GUIDELINES TO NRDC feb 24 2014

Adaptive Decision Making, ContinuedRules of thumbExplorationA rule of thumb is a rule based on practical experience and habit. Examples:x When ahead in the count (0-2), a pitcher will waste the next pitch.x Lenders limit mortgages to three times a borrower's annual income.x Leasing firms replace rental cars at sixty-thousand miles.Rules of thumb have both advantages and disadvantages:AdvantagesDisadvantagesx They usually work.x They have exceptions.x Make life simpler.x Are sometimes biased.x Save time.x Can cloud judgment.Use information available to probe for a solution. Exploring is a modifiedtrial-and-error strategy to manage risk. Unlike a throw of dice, exploringproceeds cautiously in small steps toward a solution.To make exploratory decisions, take these steps:StepAction1 Proceed tentatively on a course.2 Along the way, assess situation to see if you're on the right path.3 Then adjust to either change, abandon, or stay the course.DecisionstaggeringMixedscanningMake incremental decisions to achieve an objective and avoid up-frontcommitment to an irreversible decision.Example: Before installing central air-conditioning, try screens, shades, andfans. These alone may achieve the purpose. If not, they will still have helpedcool the building and increase efficiency of air-conditioning if later installed.Using these steps, physicians avoid committing to a single, incomplete diagnosis:StepAction1 Assess patient's condition.2 Isolate symptoms.3 Cautiously begin treatment.4 Reassess patient's condition: If the patient—x Improves, stay with treatment.x Fails to improve, switch treatment.As they learn more, they determine cause of the illness and its cure. Thisapproach enables physicians to avoid making two bad decisions:• Diagnosing a well person as sick.• Diagnosing a sick person as well.NRDC GRC – Staff Handbook 5-11