A Decision-Making Model for More Effective Decision …

1 DECIDEA Decision - making Model for More EffectiveDecision making by Health Care ManagersKristina L. Guo, PhD, MPHThe purpose of this article is to describe a step-by-step process for Decision making , and a modelis developed to aid health care managers in making more quality decisions, which ultimatelydetermines the success of organizations. The DECIDE Model is the acronym of 6 particularactivities needed in the Decision - making process: (1) D = define the problem, (2) E = establish thecriteria, (3) C = consider all the alternatives, (4) I = identify the best alternative, (5) D = developand implement a plan of action, and (6) E = evaluate and monitor the solution and feedback whennecessary. The DECIDE Model is intended as a resource for health care managers when applyingthe crucial components of Decision making , and it enables managers to improve their Decision - making skills, which leads to more Effective decisions.

2 Key words: Decision making , decisionmodel, Decision processes, health care managerHEALTH CARE MANAGERS operate in anincreasingly complex system. With nume-rous economic, legal, ethical, organizational,and technical changes taking place, mana-gerial Decision making has a direct impact onindividuals in the workplace and on the per-formance of the organization and is influ-enced by a multitude of other factors thatcould result in financial success, customersatisfaction, and long-term viability for theorganization. Decision making is inherent inall managerial functions and is closely relatedto the planning function. Regardless of level,all managers make decisions, although thedecisions made by senior managers have abroader scope, affect more individuals, andhave a greater impact than those made byfirst-line supervisors. Decision making is aprocess of choosing the best alternative toachieve individual and organizational objec-tives.

3 Not all managers know the processesto Decision making . Identifying and using thedecision- making process help managers tomake more Effective decisions. Although sev-eral Decision - making models and processeswere found in the literature review, thisarticle is different because it is intended toadd to the existing research. The purposeof this article is to describe a step-by-stepprocess for Decision making , and a Model isdeveloped to aid managers in making morequality decisions, which ultimately deter-mines the success of organizations. Specifi-cally, an application of the Decision -makingmodel is presented using a health careexample, thus enabling health care managersto improve their Decision - making MODELSS everal different Decision - making process-es and models were found in the and their relevance are dis-cussed here. The basic components of thesemodels are similar.

4 For instance, the militarymodel occurs in 5 begins withdefining the objective in which needs andoptimum outcomes are identified. In thesecond step, all available resources are dis-cussed. Third, a plan is established in whichThe Health Care ManagerVolume 27, Number 2, pp. 118 127 Copyright#2008 Wolters Kluwer Health |Lippincott Williams & WilkinsAuthor Affiliations: Department of PublicAdministration, Health Care AdministrationProgram, University of Hawaii West author: Kristina L. Guo, PhD, MPH,Department of Public Administration, Health CareAdministration Program, University of Hawaii WestOahu, 96-129 Ala Ike, Pearl City, HI @ 2008 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is manager writes down the specific actionrequired. The fourth step involves laying outthe course of action so that checkpoints aredetermined to make sure that objectives aremet.

5 The final step is to provide closure inwhich accomplished objectives are indi-cated. This Model can be used to implementdecisions; however, specific details are notadequately described. Statements are ambig-uous and lacking in clarity to truly aidmanagers in making decisions. For instance,in the last step, closure is made up of thosefinal benchmarks of success to indicate thatthe plan was statement isvague and does not provide managers withdirection or adequate information on how toproceed with parliamentary Model occurs in 8 stepsand is similar to the military Model . The8 steps are the following: (1) establish need,(2) define the optimum outcome, (3) con-duct a stakeholder review, (4) list the prosand cons, (5) make an option review, (6)review potential consequences, (7) formu-late a step-by-step plan, and (8) , this Model does not provide specif-ics.

6 For example, in step 7, establishing aplan does not clarify the kinds of informationneeded for the plan to be successfullyimplemented. Furthermore, a third decisionmodel combines elements from both themilitary and parliamentary models. Knownas QUICK, this Model focuses on quicklymaking decisions and executing action. Itconsists of 5 particular activities in thedecision- making process: question appropri-ate parties, understand your objectives,investigate all options, communicate clearlyto all concerned, and keep on top of thingsby monitoring process. However, the QUICK Model lacks detail about the specific activi-ties required. Overall, this Model is notcomprehensive or well ALTERNATIVE Model FORDECISION MAKINGA fter a review of the literature on decisionmaking, this article proceeds to describe analternative Decision - making Model to helphealth care managers in the Decision -makingprocess.

7 A Decision - making process consistsof a series of steps that managers take toarrive at the Decision . The purpose is tocreate a systematic Model for decisionmaking. That is, if managers use an organizedand precise process, then the chances ofmore successful and Effective decisions willresult compared to that of disorganized andunsystematic processes. This article de-scribes a Decision - making process using theacronym DECIDE. Each letter of the acronymDECIDE stands for 1 of 6 specific activitiesthat must be carried out before proceedingto the next step. The 6 steps in the DECIDE Model is illustrated in Figure 1 and is listedbelow:1. D = define the E = establish the C = consider all the I = identify the best D = develop and implement a plan E = evaluate and monitor the solutionand feedback when assist managers in making decisions,Figure 2 is an application of the DECIDE Model using a health care = define the problemDecision making is a problem-solvingprocess that aims to eliminate barriers toachieving individual or organizational defining problems or determining whatthe barriers are, then managers can takesteps to remove these barriers.

8 However,defining the problem is not an easy task. Itcan be a time-consuming process. A managermust question the staff and monitor dailyactivities and tasks to fully investigate theextent of the problem. Dunn2suggests thatwhat often appears as a problem may only bea symptom and digging deeper can lead tothe real problem. For example, senior man-agement noted that many employees werelate to work and showed negative attitudestoward each other and the patients. Therewas increased disagreement among staff, Decision - making Model for Health Care Managers119 Copyright @ 2008 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is caused many to feel unhappy in theworkplace, and ultimately, they chose tovoluntarily terminate their employment atABC Health Care System. The symptomsshowed dissatisfied and unmotivated work-ers.

9 Upon further investigation, senior man-agement found that the real problem wasa lack of communication, supervision, anddirection by department level managers. As aresult, the staff were disgruntled, which ledto high turnover. To clearly define the realproblem, an individual manager should beconcerned with 3 basic questions: (1) whatis the problem? (2) Why should anythingbe done at all? (3) What should or could behappening? According to Arnold,3a decisionis necessary under these conditions:1. Something has happened that should nothave happened. Thus, corrective actionis necessary. For example, all patientmedical records were inputted into anew computer database, and mysteri-ously, all records were lost. The chiefinformation officer recognizes that a se-rious problem has occurred, and an ac-tion must take place to correct the Something can happen and should beprevented.

10 For instance, at the SummitAmbulatory Surgery Center, signs wereposted to inform patients that renova-tions and expansions are taking place tobetter serve patients. Because part ofthe clinic which houses medical sup-port staff and office equipment is be-ing renovated, the insurance claimsspecialist along with the copy and faxmachines that she needs for her workwere temporarily put in the patientFigure : a Model of the Decision - making JUNE2008 Copyright @ 2008 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is room. One afternoon, the pa-tient registration coordinator was busywith patients, and the claims specialistwas out for lunch. A patient walked byand saw that a fax was coming throughand fell to the floor. She picked it up andwas about to sit down to read throughit. Just then, a manager walked by andsaw what had occurred.