Before you make that big decision...

Daniel Kahneman; Dan Lovallo; Olivier Sibony

Commentary

Before you make that big decision...

July 20, 2011

Kahneman D, Lovallo D, Sibony O. Harv Bus Rev. 2011;89(6):50-60, 137.

View more articles from the same authors.

This commentary, whose first author won a Nobel prize for his seminal work on cognitive shortcuts that underlie many errors, discusses cognitive biases and provides a checklist to help prevent biases in decision making.

PubMed citation

Available at

Related Resources From the Same Author(s)

A machine learning-based clinical decision support system to identify prescriptions with a high risk of medication error.

October 21, 2020

Diagnostic error: untapped potential for improving patient safety?

August 13, 2014

Crime in the workplace, part 1.

October 24, 2007

Failure to report poor care as a breach of moral and professional expectation.

June 19, 2019

The influence of the availability heuristic on physicians in the emergency department.

November 17, 2021

An effective intervention: limiting opioid prescribing as a means of reducing opioid analgesic misuse, and overdose deaths.

September 23, 2020

Innovation in safety, and safety in innovation.

January 29, 2014

Special report: COVID deepens the other opioid crisis - a shortage of hospital painkillers.

June 24, 2020

Comparison of three methods for estimating rates of adverse events and rates of preventable adverse events in acute care hospitals.

March 6, 2005

Nurse workarounds in the electronic health record: an integrative review.

August 12, 2020

Zero harm in health care.

March 18, 2020

Improving process while changing practice: FMEA and medication administration.

March 12, 2008

Association of unexpected newborn deaths with changes in obstetric and neonatal process of care.

January 20, 2021

Adverse events in medicine: easy to count, complicated to understand, and complex to prevent.

September 9, 2009

Review of medication error sources associated with inpatient subcutaneous insulin: recommendations for safe and cost-effective dispensing practices.

August 24, 2022

Patient safety in geriatrics: a call for action.

December 15, 2010

Evidence for anchoring bias during physician decision-making.

July 12, 2023

Acute stroke chameleons in a university hospital: risk factors, circumstances, and outcomes.

August 5, 2015

POPI (Pediatrics: Omission of Prescriptions and Inappropriate prescriptions): development of a tool to identify inappropriate prescribing.

September 3, 2014

Nurses' perception of shift handovers in Europe - results from the European Nurses' Early Exit Study.

February 21, 2007

Utilizing information technology to mitigate the handoff risks caused by resident work hour restrictions.

May 26, 2010

An evidence synthesis on perioperative handoffs: a call for balanced sociotechnical solutions.

April 5, 2023

How do black-serving hospitals perform on patient safety indicators?: Implications for national public reporting and pay-for-performance.

December 1, 2010

Unexpected intraoperative patient death: the imperatives of family- and surgeon-centered care.

February 20, 2008

Adverse health events related to self-medication practices among elderly: a systematic review.

May 31, 2017

Analysis of overridden alerts in a drug–drug interaction detection system.

October 22, 2008

November 20, 2013

Effect of crew resource management training in a multidisciplinary obstetrical setting.

May 21, 2008

Maximizing student potential: lessons for pharmacy programs from the patient safety movement.

May 17, 2023

Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis.

May 20, 2020

Learning from tragedy: the Julia Berg story.

December 12, 2018

Lessons from walking the medical distancing tightrope.

July 22, 2020

Workplace engagement and workers' compensation claims as predictors for patient safety culture.

October 17, 2012

Medication safety in older adults: home-based practice patterns.

June 22, 2005

In search of common ground in handoff documentation in an intensive care unit.

May 23, 2012

Are you listening...Are you really listening?

September 17, 2008

Residents' perceptions of professionalism in training and practice: barriers, promoters, and duty hour requirements.

July 19, 2006

High-alert medication administration and intravenous smart pumps: a descriptive analysis of clinical practice.

July 31, 2019

A multicomponent fall prevention strategy reduces falls at an academic medical center.

September 6, 2017

Standardizing concentrations of adult drug infusions in Indiana.

June 7, 2017

Drug administration errors and their determinants in pediatric in-patients.

September 7, 2005

Effective triage can ameliorate the deleterious effects of delayed transfer of trauma patients from the emergency department to the ICU.

June 3, 2009

Comparative effectiveness of a serious game and an e-module to support patient safety knowledge and awareness.

February 22, 2017

Use of a daily goals checklist for morning ICU rounds: a mixed-methods study.

April 30, 2014

Predictors of prescription errors involving anticancer chemotherapy agents.

February 15, 2012

Resident supervision and patient safety: do different levels of resident supervision affect the rate of morbidity and mortality cases?

August 26, 2015

A comprehensive pharmacist intervention to reduce morbidity in patients 80 years or older: a randomized controlled trial.

May 20, 2009

Diagnostic stewardship—leveraging the laboratory to improve antimicrobial use.

August 16, 2017

Detecting adverse events in dermatologic surgery.

January 6, 2010

Diagnostic stewardship to prevent diagnostic error.

March 15, 2023

The promise of big data: improving patient safety and nursing practice.

April 27, 2016

National surveillance of emergency department visits for outpatient adverse drug events in children and adolescents.

March 5, 2008

Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis.

October 5, 2022

Taking the blame: appropriate responses to medical error.

January 30, 2019

Labeling solutions and medications in sterile procedural settings.

May 3, 2006

Accuracy of emergency department clinical findings for diagnosis of coronavirus disease 2019.

July 29, 2020

Automated identification of antibiotic overdoses and adverse drug events via analysis of prescribing alerts and medication administration records.

August 24, 2016

How to improve change of shift handovers and collaborative grounding and what role does the electronic patient record system play? Results of a systematic literature review.

July 10, 2013

Deafening silence? Time to reconsider whether organisations are silent or deaf when things go wrong.

August 6, 2014

Potentially inappropriate prescribing in elderly veterans: are we using the wrong drug, wrong dose, or wrong duration?

August 24, 2005

Medical error—the third leading cause of death in the US.

May 11, 2016

Improving healthcare quality through organisational peer-to-peer assessment: lessons from the nuclear power industry.

June 6, 2012

Organisational failure: rethinking whistleblowing for tomorrow's doctors.

September 7, 2022

Communication errors in dispatch of air medical transport.

December 8, 2010

Essay: the political logic of regulatory error.

November 30, 2005

Accuracy of adverse-drug-event reports collected using an automated dispensing system.

July 6, 2005

US poison control center calls for infants 6 months of age and younger.

January 27, 2016

Development of an electronic pediatric all-cause harm measurement tool using a modified Delphi method.

December 7, 2016

US emergency department visits attributed to medication harms, 2017-2019.

October 20, 2021

Documenting the indication for antimicrobial prescribing: a scoping review.

November 2, 2022

Emergency department visits for outpatient adverse drug events: demonstration for a national surveillance system.

April 21, 2005

National surveillance of emergency department visits for outpatient adverse drug events.

October 18, 2006

Simulation safety first: an imperative.

February 20, 2019

Giving voice to quality and safety matters at board level: a qualitative study of the experiences of executive nurses working in England and Wales.

August 24, 2016

Surgical complications: disclosing adverse events and medical errors.

January 16, 2013

Time to sign off on signout.

July 20, 2011

The stories clinicians tell: achieving high reliability and improving patient safety.

December 2, 2015

From To Err Is Human to Improving Diagnosis in Health Care: the risk management perspective.

March 2, 2016

An approach to assessing patient safety in hospitals in low-income countries.

June 3, 2015

The ethics of empowering patients as partners in healthcare-associated infection prevention.

April 9, 2014

Reportable incidents.

March 25, 2009

Effect of the 50-hour workweek limitation on training of surgical residents in Switzerland.

June 30, 2010

Use of recalled devices in new device authorizations under the US Food and Drug Administration's 510(k) pathway and risk of subsequent recalls.

January 25, 2023

Effect of a comprehensive obstetric patient safety program on compensation payments and sentinel events.

March 23, 2011

Learning from errors and resilience.

May 24, 2023

Team types, perceived efficiency and team climate in Swedish cross-professional teamwork.

April 27, 2005

Adverse drug reactions and therapeutic errors in older adults: a hazard factor analysis of poison center data.

November 22, 2006

Accidental iatrogenic pneumothorax in hospitalized patients.

March 15, 2006

Assessment of adverse drug events among patients in a tertiary care medical center.

November 29, 2006

Nurses' safety motivation: examining predictors of nurses' willingness to report medication errors.

August 7, 2019

Prevalence, risk factors, and outcomes of idle intravenous catheters: an integrative review.

August 3, 2016

Establishing a safe container for learning in simulation: the role of the presimulation briefing.

October 8, 2014

Contingency planning for electronic health record–based care continuity: a survey of recommended practices.

October 15, 2014

We know what they did wrong, but not why: the case for 'frame-based' feedback.

May 29, 2013

Wrong-site craniotomy: analysis of 35 cases and systems for prevention.

September 15, 2010

Adverse drug events among hospitalized Medicare patients: epidemiology and national estimates from a new approach to surveillance.

January 13, 2010

Role of clinical context in residents' physical examination diagnostic accuracy.

April 13, 2011

Addressing structural racism in pediatric clinical practice.

August 23, 2023

Designing a safer radiology department.

March 29, 2012

The hard talk: dealing with the disruptive physician.

January 20, 2021

Related Resources

Patient Safety Innovations

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

July 31, 2023

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

Systems approach to health service design, delivery and improvement: a systematic review and meta-analysis.

February 3, 2021

Creating a framework to integrate residency program and medical center approaches to quality improvement and patient safety training

January 13, 2021

High-Performance Work Systems in Health Care Management: Parts 1-5.

October 4, 2020

Beyond the corrective action hierarchy: a systems approach to organizational change.

August 26, 2020

Tolerance of uncertainty and the practice of emergency medicine.

July 15, 2020

Managing teamwork in the face of pandemic: evidence-based tips.

June 24, 2020

Reducing Diagnostic Error: Measurement Considerations.

August 14, 2019

Managing risk in hazardous conditions: improvisation is not enough.

July 24, 2019

Patient Safety Ethics: How Vigilance, Mindfulness, Compliance, and Humility can Make Healthcare Safer.

July 24, 2019

Physician impairment and rehabilitation: reintegration into medical practice while ensuring patient safety: a position paper from the American College of Physicians.

June 19, 2019

How organisations contribute to improving the quality of healthcare.

June 12, 2019

Can we import improvements from industry to healthcare?

May 1, 2019

Inpatient notes: just what the doctor ordered—checklists to improve diagnosis.

May 1, 2019

Structural racism--a 60-year-old black woman with breast cancer.

April 10, 2019

Teamwork- Part 1: Divided We Fall; Part 2: Cursed By Knowledge: Building a Culture of Psychological Safety; and Part 3: The Not-My-Problem Problem.

March 6, 2019

Integrating patient safety education into early medical education utilizing cadaver, sponges, and an inter-professional team.

November 7, 2018

Error disclosure in pathology and laboratory medicine: a review of the literature.

August 31, 2016

Using Kotter's change model for implementing bedside handoff: a quality improvement project.

August 24, 2016

Improving safety for hospitalized patients: much progress but many challenges remain.

August 17, 2016

Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Third Edition.

June 22, 2016

Encouraging employees to speak up to prevent infections: opportunities to leverage quality improvement and care management processes.

May 18, 2016

Re-examining high reliability: actively organising for safety.

May 18, 2016

Impact of organizations on healthcare-associated infections.

April 1, 2015

Enhancing the effectiveness of team debriefings in medical simulation: more best practices.

March 11, 2015

Rethinking diagnostic delay in cancer: how difficult is the diagnosis?

January 7, 2015

Creating a physician-led quality imperative.

December 10, 2014

A qualitative study of senior hospital managers' views on current and innovative strategies to improve hand hygiene.

December 3, 2014

A model of disruptive surgeon behavior in the perioperative environment.

October 15, 2014

See More About The Topic

Health Care Executives and Administrators

Organizational Behaviorists

Cognitive Errors ("Mistakes")

Quality Improvement Strategies

Before you make that big decision...

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Before you make that big decision...

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

PSNet Log in

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site