Decision making is a necessary process in every day business. It is a basic activity that needs to be done in order to achieve short-term and long-term goals. More often than not, success or failure of an organization to achieve goals is dependent on the decisions that organizations do for performance management purposes. Hence, it is imperative for any organization to implement various decision-making tools and techniques in order to come up with the best possible decision.
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Effective decision making is critical to organizational survival; hence managers tend to seek ways to come up with the optimum decision. Intuition and serendipity are the bases for decision making in research and analysis. The manager’s previous experience may be a valid basis for decisions if this has been effective to achieve past goals. Likewise, the organization can also derive techniques from experiences of other organizations. The organization can adopt philosophical insights to apply to its own decision making needs.Thus, these could also be the bases for decision making that the healthcare professionals and organizations need. In this paper, I present decision making tools and techniques that healthcare organization like EUPHA use. Moreover, alternative tools and techniques that could have been used will also be presented. At a final note, the most effective decision making technique will be recommended based on the special needs of the organization.
Decision making: Concepts and Definitions
Decision making in health policy involves process of consultation of all groups involves in health policy-related issues. The main groups that consist the decision making body include the government, medical professional’s association, hospitals, and health insurance companies. The decision making process for healthcare research and policy is directly influenced by the national government. This process is composed of the following characteristics: government leadership, multi group mechanisms and professional organizations.
Creative approach to decision making capitalizes on its bases- intuition and serendipity. However, concrete analysis of information is necessary before considering the final decision especially for health research associations. Experimentation, research, and analysis are among the most effective and scientific means to choose among alternatives. Likewise, decision makers can evaluate alternative decisions through various decision making tools and techniques.
In the next section, decision making tools and techniques are discussed one by one. The following techniques are used for the managerial needs of healthcare professionals. Each has its special uses, advantage and disadvantages based on the needs of the health organizations.
Considered Opinion and Devil’s Advocate. In this technique, the manager obtains considered opinion of experts and use “devil’s advocate” technique to bring forth arguments for and against alternative. The management team assesses several alternatives and develops arguments. Each alternative us tested through frank discussion among members of the department. Having considered different points of view, the decision maker then selects the course of action based on the resulting comparative assessment. The advantage of this technique is that alternatives are subjected to strict, internal, and organized criticism even before implementation. However, the devil’s advocate is not an actual decision making process; rather it only makes sure that each alternative was presented and evaluated thoroughly.Another disadvantage of the technique is that it is vulnerable to personal bias and subjective judgment.
Factor Analysis Matrix. The alternative decisions are compared via a table or matrix. Under this method, the decision maker develops criteria under two categories: essential elements and desired elements. The factors named are designated with relative weights and the alternative with the highest weight is rated as the best option.The advantage of this method is that it is an effective means to eliminate personal preferences and biases for a closer chances of coming up with impartial decision.The disadvantage for this method, on the other hand, is that some factors may be overlooked and not be given weights that these factors deserve.
The Decision Tree. This is another decision making tool for healthcare managers that is used to trace possible actions that may occur from various decision points. The decision tree encourages the manager to trace possible events with respective notation of the probabilities associated with each. The decision tree includes the basic decision and the events rooting from this decision.The advantage of this technique is that it forces managers to delineate reasoning, undertake disciplined speculation of consequences, see possible constraints, and weigh the situations.This technique is particularly useful for managers who have intense personal investment on the decision to minimize emotional barriers and to come up with objective decision.
On the other hand, the disadvantage of this technique is that it is imperative that the decision maker has all the valuable information necessary in constructing a decision tree. Misleading information can tremendously affect the accuracy of the decision about to be made.Moreover, it cannot foresee external factors that may alter expected results and only one perspective, the decision maker’s perspective, is considered. Hence, the manager should not be short-sighted and should also see the picture in a wider perspective in order to anticipate the series of events from the basic decision in order to consider the most number of relevant possibilities. Likewise, this is also achievable if the decision maker has succinct information to support the consequences foreseen to occur.
Operations Research. Operations research is the application of scientific method to observe a problem, process or operation. It is a quantitative problem solving decision making tool with the use f mathematical models to management problems.First among the steps of this technique is problem formulation wherein the problem is stated without predetermined judgment and notions. Second, mathematical model or conceptual model is constructed through equations and formulas representing critical factors of the problem under observation. Third is the manipulation of variables to develop and assess alternative situation in terms of predetermined criteria. There are various types of operations research.
Simulation is the observation of the process with the use of a model or representation. In the process of developing the model, the manager seeks to gain additional information especially on the uncertainties of the situation. The manager focuses on these uncertainties and measure the degree of chance associated with each.This technique compensated legal, ethical and economic constraints to manipulate reality in order to observe. Hence, models are logical but rather simplified representation of the relevant aspect of reality and ranges from simple physical models to complex mathematical equations. Healthcare professionals, for example may use physical models such as a model of a body organ.
Gaming is the simulation of competitive situations in which situations are represented in a competitive manner to influence the manager’s decision. This decision making technique is used to derive human decision but can sometimes be computer-assisted. On the other hand, Game theory is one branch of mathematical analysis of conflict and strategy and is associated with the concepts of zero sum games and minimax strategy. However, this remains undeveloped because of complexities once the number of contestants and rules increased.
Another type of operations research is stochastic simulation, a model designed to include elements of randomness. Since the variables are uncertain, at least a sample of their values may be assigned through the development of statistical distribution pattern. Hence, the healthcare manager can simulate, for example, employee absenteeism, patient arrivals, and equipment failure.
The last type of operations research theory is waiting line and Queuing theory. Demand for healthcare products and services fluctuate. Hence, the manager must balance cost of waiting lines with that of the cost of preventing waiting lines through increased service. Waiting lines are common especially in hospitals where patients have to wait in lines for queues. Waiting line or Queuing theory is useful for analyzing situations in which units to be provided for services are relatively predictable. The three basic components of this theory include arrivals, servicing, and queue disciplines. Furthermore, arrivals are divided in three categories: predetermined, random and combination. Servicing is the focal point of analysis in terms of the number of units and time needed for each pattern of distribution. Lastly, queue discipline is the analysis of patterns of the waiting line including average minimum and maximum wait, number of lines and which units are often selected for service. The analysis of such information helps the manager to overcome negative aspects of waiting lines and to minimize the cost to the organization.
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The main advantage of operations research compared to other decision making technique is that it offers various methods of implementation. Each type may be selected based on the needs and resources available to the organization. Otherwise, all of the methods are implemented on scientific methods and objectivity is rest assured by quantitative methods of analysis. However, the main disadvantage is implementation of any operations research is the high costs, time and expertise necessary for the implementation.
Healthcare Professionals as the Decision makers
Healthcare professionals often face managerial roles in their organizations. With these two-fold roles, there might be conflicts on decision situations depending on how these situations are viewed. It is essential for the professional to learn how the perceived needs of the department must be balanced with the needs of the organization as a whole. While it is impossible to always get agreement with the organization as a whole, conflicts will be avoided through maintaining balance between the interests of the parties. After all, the departments’ interests are expected to be bounded by the goals of the total organization.
Moreover, healthcare professionals and organizations face special challenges in terms of decision making. In their case, decision making becomes more complex than ever. Factors contributing to this increasing complexity include rapid growth of research knowledge, technological sophistication, and complex laws. These factors make decision-making in the healthcare sector more and more daunting.
While others claim that research can help in decision making in the healthcare sector, in reality, it makes decision making a complex task. Hence, not only research expansion is needed. What is more necessary for this sector is to deepen health research policies.For the meanwhile, this can be dealt with the use of decision making tools mentioned above.
Healthcare professionals and organizations may implement considered opinion and devil’s advocate. This can be used through professional sharing when different perspectives from experts are available. This also encourages collaboration and takes foundation on the expression that “two minds are better than one.” This can be used simultaneously with combined options technique in order to consider the possibility that the options may not be mutually exclusive. Two factors being considered may be implemented and come to one marginal and marginal value.
Factor Analysis matrix may be used by healthcare professionals and organization when decision making is based on one perspective only. This can be seen as an argument within one’s self. Likewise, this can be combined with morphological box. This shows one aspect of the problem in relation to others. This box is technique that presents easy-to-evaluate form for analyzing problem and evaluates suggested solutions.
However, among the decision making techniques, the most appropriate to use by the healthcare professionals and organizations is operations research. The sector needs scientific methods in coming up with significant decisions to healthcare management. Regardless on the type of operations research type, the organization can choose the type based on the needs of the situation. Simulation and waiting line and queue techniques may be the most useful among these types for the healthcare sector. However, high costs of this technique must be given attention.
Faulty decision making is usually made haphazardly. Hence, decision making should be made through intensified planning and implementation of a wide variety of decision making tools and techniques. In the end, the most effective decision making technique is: 1) the one that will assure objectivity and eliminate personal biases and predetermined judgment; 2) satisfy the needs of the decision maker; and 3) bring about the most appropriate decision. It is dependent on the actual organization and the decision making situation. Even after the decision has been made, evaluation and monitoring should also be considered.
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