Factors affecting clinical decision-making at hospital emergency departments.

Abstract

Introduction: The implementationDuring the decision-making process, medical errors can occur, this is observed
in high pressure environments, mainly those with greater responsibility for human health. The problem of medical errors due to problems in decision-making is associated with a high workload, short time to carry
out the activities inherent to work, lack of command of the work area, inadequate communication and cooperation
in poor or nonexistent, leading to suboptimal levels in decision-making. The increase in VPM in the
daily clinical evaluation of patients with sepsis is an effective tool that guides timely decision-making; followup
and feedback of cases, in relation to therapeutic behavior.

Objective: Identify the factors that intervene in decision-making by medical personnel working in the emergency
area in second-level hospitals in 2 provinces of central Ecuador.

Material and methods: A qualitative, observational, descriptive study is presented. Interviews are conducted
with medical personnel who work in emergency areas in the central zone of Ecuador. Total, of participants 40
health professionals (doctors).

Result: A total of 40 respondents were included in the study; Sociodemographic data was recorded in the
surveys. The mean age of the participants was 29.8 years with a SD = 29.8 ± 4.35. The doctors who are working
in emergency rooms in 75% are young professionals with 1 to 4 years of experience within the profession,
they work 24-hour shifts, with an average attention of 90 patients per guard, arriving in some cases 10% of
respondents to pay attention to 120 patients. The hours of rest within the guard are an average of 4 hours in 24
hours. All respondents agree with indicating that work in an emergency area may be more demanding than
work in any other area of the hospital, not only because of the number of patients, the diversity and complexity
of the pathologies that are treated, which directly affects the Atention time.

Conclusions: The number of patients attended in the emergency services and the complexity of the pathologies
that patients present in the emergency rooms are factors that directly affect the decision-making process
in diagnosis and treatment due to the short time they have for the process. of medical care, due to the high
demand for care Policies that improve working conditions for health professionals are required, with a careful
evaluation of workloads and their execution times to reduce the possibility of errors in the diagnosis and / or
treatment of patients.