DECISION MAKING PROCESS

INTRODUCTION
Decision-making process is the process of selecting one course of action
from alternatives. Decision making relies on the scientific problem solving
process.

DEFINITION
Decision-making process is the deliberative, cognitive process, consisting
of sequential steps that can be analyzed and refined.
- Burton

Decision-making process is the process of selecting one course of action

from alternatives.
- Ann Marrier
STEPS IN THE DECISION MAKING PROCESS
1. Identifying the problem, analyzing the situation
2. Explore the alternatives
3. Choose the most desirable alternatives
4. Implement the decision
5. Evaluate the results

1. IDENTIFYING THE PROBLEM, ANALYZING THE SITUATION

Nurse managers can identify the problem by analyzing the situation. All
too frequently, decisions are made and implemented before all the facts have
been gathered. To prevent this the manager should have a questioning attitude.
What is the desirable situation? What are the presenting symptoms? What are
the discrepancies? Who is involved? When? Where? How? With answers to
these questions managers can develop tentative hypotheses and test them
against what they know. Progressive elimination of hypotheses that fail to
conform to the facts reduces the number of causes to be considered. Feasible
hypotheses should be further tested for causal validity. When mangers believe

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they have identified the cause or causes of the problem by analyzing available
information, they should begin exploring possible solutions.

2. EXPLORE THE ALTERNATIVES

There are usually number of ways to solve a problem. Some may be quick
and economical but less effective than their alternatives. Others may be more
effective but less economical. If various alternatives are not explored, the course
of action is limited.

3. CHOOSE THE MOST DESIRABLE ALTERNATIVE

The number and quality of alternatives depend largely on the creativity
and productivity of managers and their staff. Leadership that prevents immediate
acceptance of an apparently obvious solution and facilitates group exploration of
decision-making opportunities (such as problems to solve) usually increases the
number of alternatives and the quality of problem solving

4. IMPLEMENT THE DECISION

After a decision has been made, it must be implemented. A decision that is
not put into action is useless. The manager will need to communicate the
decision to appropriate staff associates in a manger that does not arouse
antagonism. The decision and procedures for its implementation can be
explained in an effort to win the cooperation of those responsible for its
implementation.

5. EVALUATE THE RESULTS

The final step of decision-making is evaluation of the results of the
implementation of the chosen alternative. Evaluative criteria may have to be
developed. Audits, checklists, ratings, and rankings can be used to review and
analyze the results. Because solutions to old problems sometimes create new
problems, additional decisions may need to be made and evaluated.

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ELEMENTS OF CRITICAL THINKING AND REASONING
 Purpose or goal
 Central problem or question at issue
 Point of view or frame of reference
 Empirical dimension
 Conceptual dimension
 Assumptions
 Implications and consequences
 Inference and conclusions

CREATIVE DECISION-MAKING
The creative process
The first phase of the creative process is a felt need. Similarly, when
decision-makers are confronted with a problem, they start seeking a solution.
The second phase of creative problem solving is a work stage known as
preparation, from which creative ideas emerge, innovation is partially dependent
on the number of options considered. By exploring relationships among potential
solutions, one may identify additional solutions.
The third phase, is a period for pondering the situation. Repetition of the
same thought, with no new ideas or interpretations, is a sign of fatigue and
indicates that it is a good time to start the incubation period. Switching one’s
attention provides a necessary respite, and yet the unconscious mind continues
to deal with the problem. A time should be set to reexamine the situation and
review the data collected during the preparation phase.

ENCOURAGING CREATIVITY
 Brainstorming
 Brain writing
 Collective notebook technique
 Convergent thinking
 Delphi technique
 Divergent thinking

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 Drawing
 Forecasting alternative future scenarios
 Lists
 Meditation
 Modeling
 Reverse brainstorming
 Stepladder technique
 Synetics
 Visualization

1. Convergent thinking
The problem is divided into smaller and smaller pieces to find a
more manageable perspective
2. Divergent thinking
One’s view of the problem is expanded. The problem is considered
in different ways
3. Brainstorming
Under favorable circumstances a group working together can
identify more ideas than an individual or that group of individuals working
separately. Brainstorming is a technique leaders can use to crate a free
flow of ideas
4. Collective notebook technique
A problem is identified and participants are instructed to record
thoughts and ideas about the problem for a specified period. Each
participant gives his or her notebook to another person, who reads it, looks
for patterns and synthesizes the content. The participants then meet,
analyze the results, and make recommendations to solve the problem
5. Stepladder technique
This technique structures the entry of group members into the
group to ensure that each member contributes to the decision-making
process. Initially, two groups members try to solve a problem

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6. The Delphi technique
The Delphi technique allows members who are dispersed over a
geographic area to participate in decision-making without meeting face to
face. A problem is identified, and members are asked to suggest potential
solutions through the use of a questionnaire
7. Lists
The checklist method is used to assemble criteria on a checklist,
sort it, prioritize it, eliminate items, and add others. An attribute list records
characteristics.
8. Drawing
Drawings can be used to evoke and record creative insight because
intuitive consciousness communicates more readily in symbols and
impression than in words
9. Synetics
Synetics is the joining together of apparently irrelevant elements. A
problem is identified and a brief analysis given.
10. Visualization
Free association can be used to create a big dream approach. First,
desired outcomes are visualized and then visually run backward to identify
a new approach
11. Forecasting alternative future scenarios
The future is often more a matter of choice than of chance. The
choice is enhanced by forecasting potential scenarios – status quo, least
preferred, most preferred, and not likely – and selecting the most desired.
12. Modeling
Look at how others are doing what you wish to do. However, be
cautious: what works for someone else, somewhere else, may not work for
you here and now.
13. Meditation
The optimal state for peak performance of athletes is relaxed
concentration, or “playing loose”. Meditation can generate a more focused
state of relaxed.

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ETHICAL ASPECTS OF DECISION-MAKING
Ethics is a moral philosophy, a science of judging the relationship of
means to ends, and the art of controlling means so they will serve human ends. It
involves conflict, choice and conscience. When there is a conflict, there is a
choice between conflicting alternatives. The choice influenced by values. Values
are learned first from important adults and are modified by association with
people of different values. Value modification and reinforcement are lifelong
processes, a value is consciously prized and cherished, freely chosen from
alternatives, and acted on in a variety of ways. Ethical choices must also
consider wants, needs, and rights: people may want what they do not need.

MORAL REASONING
Levels of more development have been identified as (1) pre-moral or pre-
conventional when behaviour is motivated by social or biological impulses with no
sense of obligation to rules (2) conventional when the person accepts standards
of the group with little critical reflection, use literal obedience to the rules, and
feels obligation; and (3) autonomous when the person thinks and judges for
himself, considers the purpose and consequences of the rules, and does not
accept the group standards without reflection.

CONCLUSION
Decision-making process relies on scientific problem solving process:
Recognizing and defining the situation, Identifying alternatives, Evaluating the
alternatives , selecting the best alternatives, implementing the chosen alternative
and Follow-up and evaluation.

BIBLIOGRAPHY
1. Gene Burton, “Management Toady – Principles and Practice”, 1 st edition,
Mc. Graw Hill Companies, Pp: 98 – 106.
2. Ann Marrier, “Nursing Management and Leadership”, 5 th edition, Mosby
Publications, Pp: 27 - 32