This... is disturbing. Thanks for sharing this education... I think.

I am not sure equating judgement to decision rules is appropriate
Decisions rules are simplified - pared down judgement; they are rigid; they don't have anything like the complexity of expert judgement

Both should be studied
Thus far, rules have essentially never won

For us it’s about exactly the elements in your last paper - recognising that sometimes the situation doesn’t fit the protocol or policy. The reporting provides an opportunity to ascertain whether the policy needs to change.

Has NSW ambulance published on their program?
Seems like the kind of thing Casey and I like to banter about

Nice! It might interest you to know that NSW ambulance has pathways for reporting and analysing “variance to practice”, another thing I think many hospitals could learn from.

I like the idea of measuring variance, but I always worry about the set point
Excellence is variance from baseline, but not something to be wheeled in
Most attempts to diminish variance I have seen in North America seem to aim more towards mediocracy