Wikipedia wrote:Heuristic (Greek: "Εὑρίσκω", "find" or "discover") refers to experience-based techniques for problem solving, learning, and discovery. Heuristic methods are used to speed up the process of finding a satisfactory solution, where an exhaustive search is impractical. Examples of this method include using a "rule of thumb", an educated guess, an intuitive judgment, or common sense.
In more precise terms, heuristics are strategies using readily accessible, though loosely applicable, information to control problem solving in human beings and machines.
Is this patient likely to end up admitted (and therefore a candidate for intensive care management) or not? It is a question asked and dealt with in my line of work. I've written models to predict this in a previous job, and my peers who work around the corner from me at work today have written their own. The model is run every day with near-real-time data, and case managers get files delivered to them - complete with phone contact information - which prompt them to call Mrs. Jones and ask her how we can help her. It's pretty cool stuff.
In our line of work we are brutally objective about our decisions. We test our models (artificial intelligence decision making) with real data and create a Truth matrix like the one below.
The models we build essentially predict a probability that a certain thing will happen or will be true. At some point you need to fish or cut bait. Where is the cut-off point beyond which you assume it's worth managing a patient? That is determined by the penalties associated with a Type I vs. a Type II error. If we decide to intervene when they wouldn't have been a case, it costs the company the price of the case management. That's not trivial. If we decide not to intervene and we end up with the patient in the hospital, it costs us at the least the price of the inpatient admission. At the very worst, some of these people may die.
THE MODEL WILL NEVER BE PERFECT. That you need to establish from the beginning. You go forward with as good a model as you can (a very narrow gray area) and adjust your intervene or not based on your tolerance for the various errors.
Heuristics are applied by the soldier, the LEO, and the self-defense practitioner. I am in front of my apartment and someone puts a gun to me. They tell me they want me to go to location B.Should I stay or should I go now?
If I go there will be trouble
An’ if I stay it will be double
So come on and let me know!
Heuristics are there to guide us at these critical moments where a quick decision must be made and our brains may be neurohormonally jacked. Heuristics tell us to stay and to make our stand NOW, because "the second crime scene" generally does not give us a good outcome.
- Sometimes we stay and make a stand when a better outcome would be had if we went.
- Sometimes we go where the perp wanted us to, when the "rule of thumb" decision to stay would have given us a better outcome.
Heuristics help us with the odds when there is a need to make a quick decision. As with the artificial intelligence situation studied ad nauseum in the lab, we proceed knowing that there's a chance we may make the wrong decision.
As such... the "rules of thumb" - hopefully informed choices - are guideposts. But they are not hitching posts. If you have better information... If that little man in your lower brain which DeBecker talks about is whispering to you... If you suddenly feel confident enough to proceed with a "Plan C", well... Even in our purely analytical world we may put a second model at the end of a first model. Or we tell the nurse managers that the information we give them is there to help them on their jobs, but not to do their jobs for them.
Just be careful not to go into deer-in-the-headlamps mode. Kata which teach us always to breathe - even when we're not moving - help us here. Kata and kumite which teach us how to move constantly and fluidly (note the water analogy) help us here.
Experience helps us as well. There are heuristics, and then there are Heuristics.
One final point worth making... If we make an informed choice in a self-defense situation and the situation turned out badly, it's important not to beat yourself up about it later on. Even if you make a "bad" decision and it turns out badly, there is no point giving the perp a second more of your mental and psychological energy. You "dust yourself off" as best as is humanly possible, and you move on. If you need help with the moving on process, get help. But whatever you do... be decisive, accept the consequences, and then fight the "moving on" battle just as vigorously as you fought the enemy at the point of confrontation.
Easier said than done, I know... In our medical work we have the advantages of large numbers. We know mistakes will be made, but we know we can constantly tweak things to make those mistakes fewer and fewer. We can feel good about the net. A single person's life doesn't quite operate that way. It's one person and there are no do-overs. A mistake can mean anything from psychological trauma to physical disability to death. But if we are alive... we owe it to ourselves to move on.