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extracorporeal membrane oxygenation

The role of cognitive ergonomics in medical decision making

Daily work in the ICU involves multitasking and responding to unpredictable events, such as patient decompensation and interruptions. These features combine to produce an environment in which providers must rely on implicit knowledge and internal task management schema to guide the prioritization and performance of tasks. Given what is known about human cognition and the complexity of decision making in an average ICU [14], it is objectively unreasonable to expect a human being to perform at this level without committing occasional – even regular – errors. A better understanding of the interactions and behaviors that result in effective medical decision making will lead to the development and adoption of integrated decision supports that reduce the potential for diagnostic error and therapeutic harm (Figure ​(Figure33).Figure 3

Cognitive science – understanding how health care providers make decisions and what motivates them to act. A greater understanding of how providers identify high value environmental data cues, incorporate them into mental models of patient states and develop a plan of care that can be acted upon by a multidisciplinary team is essential if we are to develop smart environments that support that activity.