In this article, we aim to describe the practical aspects of research actions that should be taken into account when two methods--the think-aloud technique for data collection and protocol analysis as an analysis technique--are combined with research of decision making in acute clinical settings. These methods are rarely used together or written about in health care research. In addition, careful consideration of the pros and cons of study sampling, data collection, data management, and analysis techniques or approaches is still lacking when these methods are used in health care research. We discuss the background of the think-aloud technique and protocol analysis and review previous studies that have used these methods. The examples in the article are based on our study, in which we investigated the decision making of critical care experts. We find that the combination of the think-aloud technique and protocol analysis is applicable when investigating complex and overlapping decision-making processes and rapid, ad hoc decisions made by critical care experts.

Healthcare is an information-intensive field, as information is needed to make strategic, tactical, and operational decisions. The purpose of this study was to identify the tactical decisions that middle management healthcare managers make, the information that is available, and the necessary information that is missing using the cardiac care process as an example. Data were collected through focused interviews of nurses and physicians who work in middle management in a secondary healthcare field. The interviews were coded and analyzed using the thematic content analysis method. We identified two main categories of tactical decisions: those concerning the process of care and those concerning the resources for the care. We termed the categories "process decisions" and "resource decisions." The availability of information varied. Much of the necessary information was created and processed manually. Our results show that the collection, mining, and systematic use of information are difficult because of the existence of many types of information systems and their varying abilities to produce and report information. Finally, much of the important information is missing. In conclusion, the information management process in healthcare settings needs to be improved, and a new generation of information system is needed to support tactical decision making in middle management.

The results can be used when planning decision support systems and when defining the nurse managers' tasks in peri-operative settings.