How organizational constraints affect nurses’ decision in triage assessment performances

Purpose: This paper aims to investigate the performances of decision-making process of emergency department’s nurses involved in the triage level assessment. Design/methodology/approach: The authors developed a case study in two public hospitals in the South of Italy. The authors administered 25 clinical cases to nurses responsible of priority code assignment in the triage station. The authors simulated the attribution of the priority levels, and through a semi-structured questionnaire, the authors collected data and information about the cognitive process adopted for the final choice. Findings: The quantitative and qualitative data allowed the authors to verify that there is an impact of the organizational context on heuristics used in the decision-making process. Research limitations/implications: The research limitations are that empirical data have been collected only in two emergency departments. Practical implications: The practical implications of this paper are that organizations for improving business performances must consider the judgements are often the results of heuristics embedded in a specific structure of social and physical environment, according with the “ecological view” of rationality. Originality/value: The authors’ methodological approach contributes to analyze the performances of the triage process, verifying if the eventual errors are linked to individual or organizational factors, but above all how organizational constraints influence decision-making processes in organizations and, consequently, business performances.