In the past battlefields were often obscured due to fog, gun smoke and poor visibility. Decisions may need to be made despite uncertainty. A goal of good management is to dispel the fog as much as possible.

In German: nebel des krieges (Carl von Clausewitz)


Factors that may contribute to uncertainty or make good decisions difficult in healthcare:

(1) sleep deprivation and fatigue

(2) illness

(3) side effects of medications

(4) hunger

(5) stress, fear, anxiety and post-traumatic stress

(6) misinformation (for example, false positive or false negative results)

(7) deceit

(8) lack of information


Decisions are much easier when all of the information and outcomes are known.

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