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International Journal for Quality in Health Care Advance Access published online on September 6, 2006
International Journal for Quality in Health Care, doi:10.1093/intqhc/mzl043
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© The Author 2006. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved
Accepted August 10, 2006

Article

Task uncertainty and rationality in medical problem solving

Leif Holmberg 1 *

1 Department of Business Administration, Kristianstad University, Kristianstad, Sweden

* To whom correspondence should be addressed.
Leif Holmberg, E-mail: leif.holmberg{at}staff.hkr.se


  Abstract

Quality issue. Medical problem-solving situations are characterized by various degrees of ‘task uncertainty’--i.e. uncertainty related to the definition of a problem, the effect of a technology, the value of a solution, and so on. The need for professional discretion varies and depends on the degree of perceived task uncertainty.

Suggested solution. In this report it is argued that, in order to obtain rationality in problem-solving processes, differences in the degree of task uncertainty need to be met by variation in the structure of the health care organization.

Implications. The main implications of this view are that (under norms of rationality) problem-solving processes with low task uncertainty must be organized in one way and processes with high task uncertainty in another. Furthermore, processes with high and low task uncertainty also need to be evaluated according to different standards. Some hypotheses regarding the different organizational requirements are presented.

Keywords: clinical pathways, effectiveness, evidence-based medicine, organizational performance, problem solving, quality of care.
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