Nurse managers' decisions: fast and favoring remediation.

How do nurse managers make decisions about quality issues on their units? We asked 10 nurse managers in 3 Arizona hospitals to describe how they resolved a recent quality issue. The managers tended to use a linear, but cognitively expensive strategy, often jumping from problem to solution without a clear goal and selecting solutions biased toward remedial education. Decision support tools should help managers think more systemically and efficiently, while encouraging consideration of more alternatives to reach targeted goals.