How to Cope with Complexity in Decision-Making: An Application of Fuzzy Qualitative Comparative Analysis in the Triage Process

Qualitative Comparative analysis (QCA) is a method used to test theory-based conditions considering multiple interrelated variables that lead to the same outcome. QCA has been applied in several fields (political, sociological, organizational, and marketing), but recently studies are bridging configurational analysis using fsQCA with complexity theory in sub-disciplines of business and management. This paper aims at highlighting the usefulness of QCA also in decision-making. More specifically, we show how the QCA allow researchers to figure out how the interaction between different factors (individual, organizational, environmental) affect the cognitive heuristic process. The cognitive heuristic process is a shortcut strategy used by an individual to take a decision leveraged on limited information, time and processing capacity. We consider the cognitive heuristic process of Triage, performed by nurses in the Emergency Department. The Triage process requires a complex interaction between nurses and patients within a more or less turbulent environment: verbal information (the patient’s history), visual cues (non-verbal communication), and possibly vital signs, determine the outcome of the decision-making process. Contextual factors (i.e. organizational rules and environmental constraints) and individual nurse’s experience, knowledge, and intuition can cause the variation of nurses’ decision-making in assessing the urgency of any individual patient to receive the care. In addition, we propose some practical implications to improve the Triage process based on the results of the QCA application.