Townsville Hospital and Health Service, Queensland Health, Townsville, Australia.
Human Factors and Resilience Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Leadersh Health Serv (Bradf Engl). 2021 Aug 16;ahead-of-print(ahead-of-print):454-61. doi: 10.1108/LHS-03-2021-0013.
The complex and occasionally chaotic nature of health care has been previously described in the literature, as has the broadening recognition that different management approaches are required for different types of problems rather than a "one size fits all" approach. The CYNEFIN framework from Snowden outlines a consistent cognitive approach that offers the leader and leadership team an ability to urgently apply the correct actions to a given situation. This paper proposes a variant CYNEFIN approach for healthcare.
DESIGN/METHODOLOGY/APPROACH: Consistent and accurate decision-making within health care is the hallmark of an effective and pragmatic leader and leadership team. An awareness of how one's cognitive biases and heuristics may adversely impact on this cognitive process is paramount, as is an understanding of the calibration between fast and slow thinking.
The authors propose a variant CYNEFIN approach for health care of "act-probe-sense-respond" to resolve complex and time-critical emergency scenarios, using the differing contexts of a cardiac arrest and an evolving crisis management problem as examples. The variant serves as a pragmatic sense-making framework for the health-care leader and leadership team that can be adopted for many time-critical crisis situations.
ORIGINALITY/VALUE: The variant serves as a pragmatic sense-making framework for the health-care leader that can be adopted for many crisis situations.
医疗保健的复杂性和偶尔的混乱性质在文献中已有描述，人们越来越认识到，对于不同类型的问题，需要采用不同的管理方法，而不是“一刀切”的方法。斯诺登的 CYNEFIN 框架概述了一种一致的认知方法，为领导者和领导团队提供了能力，以便将正确的行动紧急应用于给定的情况。本文提出了一种医疗保健用的 CYNEFIN 变体方法。
设计/方法/途径：医疗保健中一致和准确的决策是有效和务实的领导者和领导团队的标志。意识到自己的认知偏差和启发式可能会对这一认知过程产生不利影响，以及了解快速思维和慢速思维之间的校准至关重要。
作者提出了一种医疗保健用的 CYNEFIN 变体方法，即“行动-探测-感知-响应”，以解决复杂和时间关键的紧急情况，使用心脏骤停和不断发展的危机管理问题的不同情况作为例子。该变体方法为医疗保健领导者和领导团队提供了一种实用的意义建构框架，可以应用于许多时间关键的危机情况。
原创性/价值：该变体方法为医疗保健领导者提供了一种实用的意义建构框架，可以应用于许多危机情况。
