Date of Award

2013

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Systems Engineering

First Advisor

Park, Eui H.

Abstract

This research examines complex clinical decision-making processes in trauma center units of hospitals in terms of the impact of complexity on the medical team involved in the trauma event. The science of complex adaptive systems together with human judgment theories provide important concepts and tools for responding to health care challenges in this century and beyond. Clinical decision-makers in trauma centers are placed in urgent and anxious situations that are increasingly complex, making decision-making and problem-solving processes multifaceted. Under stressful circumstances, physicians must derive their decision-making schemas (―internal models‖ or ―mental models‖) without the benefits of judicious identification, evaluation, and/or application of relevant medical information, and always using fragmentary data. This research developed a model of decision-making processes in trauma events that uses a Bayesian Classifier model jointly with Convolution and Deconvolution operators to study real-time observed trauma data for decision-making processes under stress. The objective was to explore and explain physicians‘ decision-making processes during actual trauma events while under the stress of time constraints and lack of data. The research addresses important operations that describe the behavior of a dynamic system resulting from stress placed on the physician‘s rational decision making processes by the conditions of the environment. Deconvolution, that is, determining the impulse response of the system, is used to understand how physicians clear out extraneous environmental noise in order to have a clearer picture of their mental models and reach a diagnosis or diagnostic course of action.

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