DECISION MAKING

INTRODUCTION

Organizations operate by people making decisions. A manager plans, organizes staffs, leads,
and controls her team by making decisions. The effectiveness and quality of those decisions
determine how successful a manager will be (Benowitz, 2001).

Decision making and problem solving are ongoing processes of evaluating situations or
problems, considering alternatives, making choices, and following them up with the
necessary actions. Sources of problems are innumerable arising from many angles internally
or externally. The entire decision-making process is dependent upon the right information
being available to the right people at the right times (Drunker, 1967). In nursing, decision
making is measured in relation to professional standards. Quick decision making is a
lifesaving tool in critical care settings.

GENERAL OBJECTIVE

At the end of the discussion/ lecture, the students should be able to gain knowledge and
understanding of the decision making and problem solving processes and be able to use it in a
critical care setting.

SPECIFIC OBJECTIVES

a. Define terms.

b. Explain the steps involved in decision making.

c. State the Conditions that influence Decision-Making

d. Discuss the personal decision making styles.

e. Explain the tools used in decision making.

f. Explain the steps involved in problem solving.

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DEFINITION OF TERMS

Decision making: is the thought process of selecting a logical choice from the available
options to (Basavanthapa, 2009).

Decision making is considering and selecting interventions from a repertoire of actions that
facilitate the achievement of a desired outcome (DeLaune & Ladner, 2006).

THE STEPS INVOLVED IN DECISION MAKING

1. Identification of the problem

The first step is to define the accurately the problem as it affects all the steps that follow. One
way that can help a manager to determine the real problem in a situation is by asking
questions such as, “What is wrong? Where is improvement needed? What are the
presentation symptoms, where is the discrepancy, who is involved, where and how? This will
assist to develop tentative hypothesis.

2. Analyzing limiting factors

The manager should have the ideal resources such as information, time, personnel,
equipment, and supplies to make an accurate decision. Relevant information can be collected
using the six helpers which are;

 What?
 Why?
 When?
 Where?
 How?
 Who?

3. Generate alternatives

 Generate several possible options.

 Be creative and positive.
 Ask “what if” questions.
 How would you like your situation to be?

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It is important to think carefully about all the possible alternatives that one could choose
from. State out the alternatives available for the situation by listing down in their order of
priority

4. Evaluation of alternatives

Look at each of the possible solutions that you have listed, and think about the advantages
and disadvantages of each. Also, consider how you feel about each of them.

5. Choose one alternative

Decide on one alternative from your list of alternatives. This choice will be based on your
information, advantages, values and feelings.

6. Implement the decision

Work out the methodology and carry out your decision. Carry out or convert the decision you
have made into a plan or a sequence of activities. Execute your plan by yourself or with the
help of subordinates. Ensure all the people involved in implementation of a solution know
about their implications

7. Evaluate your decision

Evaluate the outcome of your decision by measuring implemented result against expected
standards. Monitor your decision regularly to see whether there are any lessons. Ask yourself;
did it work? If no; why not?

TYPES OF DECISIONS

CONDITIONS THAT AFFECT DECISION MAKING

1. Certainty

Decisions are made under the condition of certainty when the manager has perfect knowledge
of all the information needed to make a decision. This condition is ideal for problem solving.
The challenge is simply to study the alternatives and choose the best solution.

2. Risk

The manager lacks complete information. He may understand the problem and the
alternatives, but has no guarantee how each solution will work. When new and unfamiliar
problems arise, non- programmed decisions are specifically tailored to the situations at hand.

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 3. Uncertainty

When information is so poor that managers can’t even assign probabilities to the likely
outcomes of alternatives. Uncertainty forces managers to rely heavily on creativity in solving
problems.

It requires unique and often totally innovative alternatives to existing processes. Groups are
frequently used for problem solving in such situations.

The responses to uncertainty depend greatly on intuition and educated guesses

PERSONAL DECISION MAKING STYLES

1. Rational/Logical decision model

This approach uses a step-by-step process, similar to the seven-step decision-making process.
It focuses on facts and reasoning. Reliance is on the steps and Decision making tools, such as
payback analysis, decision tree, and research.

2. Intuitive decision model

The managers avoid statistical analysis and logical processes. Intuition is based on years of
managerial practice and experience. These experienced managers identify alternatives
quickly without conducting systematic analyses of alternatives and their consequences.

3. Predisposed decision model

A manager decides on a solution and then gathers material to support it. Decision makers
using this approach do not search out all possible alternative. Having found a satisfactory
alternative, the decision maker stops searching for additional solutions.

TECHNIQUES OF DECISION MAKING

1. Decision trees

A decision tree shows a complete picture of a potential decision and allows a manager to
graph alternative decision paths. Generally, decision trees are used to evaluate decisions
under conditions of risk. They are a flexible method.

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 2. Payback analysis

Payback analysis comes in handy if a manager needs to decide whether to purchase a piece of
equipment. Many individuals use payback analysis when they decide whether they should
continue their education.

They determine how much courses will cost, how much salary they will earn as a result of
each course completed and perhaps, degree earned, and how long it will take to recoup the
investment.

3. Simulations

Simulation is basically model building, in which the simulator is trying to gain understanding
by replicating something and then manipulating it.

Simulations have great potential in decision making. If a manager could simulate alternatives
and predict their outcomes he or she would eliminate much of the guesswork from decision
making.

STEPS OF PROBLEM SOLVING

1. Define the problem

What is the problem and why is it happening?

A good problem definition should state the current situation and desired situation.

The current situation is defined by facts e.g. nurses reporting late for work.

2. Develop a plan

What are we going to do?

After identifying and defining the root causes brainstorm alternative solutions. E.g. call for a
meeting, get different views from individuals.

3. Implement the plan

Carry out the intervention.

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 Call upon other members to help facilitate the implementation as a way of minimizing
resistance to subsequent changes. This involves the action taken, decision making, requires
courage and its risk.

4. Evaluate the plan

The problem solver’s values will play a role in the analysis and evaluation of the
consequences. E.g. a consequence seen as very negative by one person may be perceived less
so by another.

Evaluate the implementation and its outcomes in at least two areas. e.g.

1. How you carried out the step by step problem solving process.

2. and the effectiveness of the solution implemented. Did it deliver the outcomes expected?

ASSIGNMENT

In NOT more than 2 pages, discuss the constraints faced by decision makers in an
organization.

Submit on 9th March, 2016 at 16 00hours through your class representative.

Your work can either be typed or handwritten.

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REFERENCES

Basavanthapa, BT. (2009). Nursing Management., 2nd Edition.Jaypee Brothers Medical

Publishers (P) LTD.

Benowitz E. A (2001) cliffsQuickReview Principles of Management. Hungry minds, New

York.

DeLaune, S., & Ladner, P. (2006). Fundamentals of nursing, standards and practice (3rd ed.).
Clifton Park, NY: Delmar, USA.

Drucker, PF. (1967). The effective executive. New York: Harper and Row

Kelly P. (2010). Essentials of Nursing Leadership and Management, 2nd edition, Delmar,
Clifton park, USA.