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This study demonstrates how individual paradigms implicate the questions asked, methods used and results drawn in association with a common object of study in human information behavior (HIB) research – the relationship between uncertainty and decision-making.

The author uses textual case studies to examine uncertainty and decision-making through the framework of four paradigms used in HIB research: positivism, cognitivism, collectivism and constructionism and suggests deconstructionism as a paradigm which raises new questions around this topic.

Positivistic approaches to uncertainty are often systems oriented; cognitive approaches are often user-oriented; collectivist approaches are intersubjective; and constructionist approaches blend a subjective and intersubjective research orientation. Deconstructionism raises new questions around ethics and responsibility in relation to decision-making, and the author therefore situates it as a new paradigmatic approach for this topic in HIB research.

Despite the presence of research aimed at recognizing and defining paradigms in HIB research, a comparative micro-examination of how individual paradigms implicate a specific research topic has yet to be conducted. Each paradigm uniquely shapes the ways in which uncertainty and decision-making are characterized, but the four central ones examined here have thus far left out questions of ethics and responsibility as being core elements of decision-making as tied to uncertainty. Therefore, this paper introduces deconstructionism as a paradigm new to HIB uncertainty research, arguing that it provides an important and novel complication of existent research questions and approaches.

The purpose of this paper is to identify and describe hospital quality indicators, classifying them according to Donabedian’s structure, process and outcome model and in specific domains (quality, safety, infection and mortality) in two care divisions: inpatient and emergency services.

A systematic review identified hospital clinical indicators. Two independent investigators evaluated 70 articles/documents located in electronic databases and nine documents from the grey literature, 35 were included in the systematic review.

In total, 248 hospital-based indicators were classified as infection, safety, quality and mortality domains. Only 10.2 percent were identified in more than one article/document and 47 percent showed how they were calculated/obtained. Although there are scientific papers on developing, validating and hospital indicator assessment, most indicators were obtained from technical reports, government publications or health professional associations.

This review identified several hospital structure, process and outcome quality indicators, which are used by different national and international groups in both research and clinical practice. Comparing performance between healthcare organizations was difficult. Common clinical care standard indicators used by different networks, programs and institutions are essential to hospital quality benchmarking.

To the authors’ knowledge, this is the first systematic review to identify and describe hospital quality indicators after a comprehensive search in MEDLINE/PubMed, etc., and the grey literature, aiming to identify as many indicators as possible. Few studies evaluate the indicators, and most are found only in the grey literature, and have been published mostly by government agencies. Documents published in scientific journals usually refer to a specific indicator or to constructing an indicator. However, indicators most commonly found are not supported by reliability or validity studies.