Managerial problem solving

and Decision making

1

By Yemane G/mariam (MPH in HSM)

10/05/21
Objectives of this session
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By the end of this session, the students will be able

to:-
 Define decision making and problem solving
 Describe types of decisions
 Explain problem solving & decision making model
 List problem solving steps
 Identify factors influencing problem solving &
decision making

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Meaning of a decision
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A decision is a choice between two or more

alternatives. This implies 3 things.
 When managers make decisions they are choosing---
they are deciding what to do on the basis of some
conscious and deliberate logic or judgment.
 Managers have alternatives available when they are
making a decision. It require wisdom and experience
to evaluate several alternatives and select the best one.

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Meaning of a decision…
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 Managers have a purpose in mind when they

make a decision.
 Decision making is an essential part of
modern management.
 Hundreds of decisions are made by the manager
consciously or sub consciously in his day to day
life.

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 Importance of decision making in health
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Decision making is a key part of a managers

activities.
It permeates through all managerial
functions such as planning, organizing,
directing controlling and coordinating etc.
Decision-making is integral to all
management functions, activities and roles.

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Types of decisions…
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Most of managerial decisions are of 3 types.

 Ends-means

 Administrative-operational

 Nonprogrammable- programmable

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Types of decisions…
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Ends-means;
End decisions determine the individual or
organizational objectives and results to be
achieved.
Means decisions choose the strategies or
programs and activities to accomplish
desired results.

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Types of decisions…
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E.g. a decision to emphasize quality and

productivity improvement [means]
accomplishes the organizational objectives
of enhanced quality of care and service,
higher patient or customer satisfaction
and better resource use [ends]
Ends are shown as the out put component
of the management model. Decisions
about the ends are inherent in strategic
planning, which includes formulating
objectives. Health systems may make these
decisions at corporate level.
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Types of decisions…
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Administrative-operational;
Many administrative decisions that are made
by senior level executives significantly affect
the HSO/HS and have major implications for
resource allocation and utilization.
Policy decisions are a synonym for
administrative decisions. E.g. deciding
whether to finance facility construction or
renovation using debt, without demanding a
certification election, hire hospital based
physicians, contract for laundry services,
reduce the capital equipment budget, or
participate in an integrated system of HSOs.
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Types of decisions…
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Operational decisions are made by middle

level managers and first –level managers.
They include deciding whether to purchase
non capital equipment, reassign staff, modify
work systems and modify job content.

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Types of decisions…
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Nonprogrammable-programmable;
Nonprogrammable decisions are novel,
unstructured, and significant. e.g.
whether to expand facilities, add, close, or
share services. Seek Medicare
certification of skilled beds, restructure
the organization or align with a network
of HSOs, acquire clinical information
system or add a family practice residency
program. Such decisions occur
infrequently.

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Types of decisions…
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Programmable are repetitive and routine;

procedures and rules are used to guide
them. E.g. patient admitting procedures,
scheduling, and billing and inventory supply
ordering procedures etc.
Overlap of decision types; the venn diagram
shows that three decision types may
overlap.

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 Venn diagram
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Ends
means

Non
Administrative
Programmable
operational
programmable

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 Problem solving and decision making
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Managers are problem solvers.

 Problems may be unstructured or structured,
complex or simple major or minor, urgent or
non urgent and may involve varying degrees of
cost, risk and uncertainty.
Problem solving involves a series of steps that
are characterized by intentional reasoning
about what the problem is and what the
solution should be.

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Problem solving and decision…
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Problem solving causes changes so that

actual HSO/HS results or outputs more
closely align with those desired. The
process of problem solving involves
following steps.

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 Steps decision making
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1. Reaching a decision-point (Defining the problem)

2. Exploration of the problem (Gathering information)
3. Evaluation of information (Weighing the evidence)
4. Choice of a plan of action (Choosing alternatives)
5. Taking action on your plan (Implement)
6. Clarification and review of plans (Outgoing –
Ongoing evaluation)

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 Process of decision-making
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Selecting and analyzing a situation that requires a decision

Developing and evaluating alternative solutions

Choosing an alternative

Implementing the alternative

Evaluating the results after implementation

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 Steps in problem solving
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The terms problem solving and decision making

often are used interchangeably, but are not
synonymous.
All problem solving involves decision making [i.e.
choosing among alternatives], but not all decision
making involves problem solving.
The distinction is that problem –predecision
situation assessment and post decision
implementation and evaluation. solving includes
problem analysis

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 Problem solving and decision-making model
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Predecision situation
assessment

Identifying and evaluating

Alternative solutions
Decision Alternative choice Problem
problem making
analysis
solving Post decision alternative
Solution implementation
And evaluation

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 Problem solving…
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Managers perform a series of steps when

undertaking either problem analysis or
decision analysis. As with all processes there
are variables, conditions, and situations that
influence the approach, manner and style
that are used.
Problem solving skills are crucial to
managerial success; there are situations in
which being an effective problem solver is
more important than is communication or
interpersonal skills, which is not diminish
their importance.
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Problem solving…
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In brief the manager is a problem solver

and decision maker.
Conditions that initiate problem solving
Opportunity/threat
Crisis
Deviation
Improvement

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Problem solving conditions…
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Prospective Immediate
Opportunity/ crisis
threat
Might Will
Problem solving
conditions
Seek Has/Is

Concurrent Retrospective
improvement deviation

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 Factors influencing problem solving and
decision-making
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Problem solving and decision making do not

occur in a vacuum; many factors shape how
they are performed, the style that is used, and
the outcome.
There are 3 major factors influencing in
problem solving and decision making.
Attributes of the problem solver
Nature of the situation
Characteristics of the situation.

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Factors influencing…
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Problem -solver attributes

Experience, knowledge and judgment; of the
decision maker.
The training knowledge and experience of
clinical staff such as physicians, nurses and
pharmacists are essential to high quality
patient care

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Factors influencing…

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Perspective, personality, and biases

The problem solvers perspective and
personality influences problem solving and
decision-making.
Perspective determines how the problem
solver views a problem or situation. Problem
solvers with narrow perspective [tunnel
vision] and who think vertically rather than
horizontally approach are more likely to
make lower-quality decisions.
Bias also affect problem solving and making
assumptions allows a decisions maker to
understand their effect on specific situation.
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Factors influencing…
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Personality traits such as temperament,

aggressiveness, self centeredness, self
assurance and self confidence as well as
tolerance for risk, change etc.
Values and philosophy; can also influence in
2 ways. Personal morals and ethics affect
assumptions and define acceptable
alternatives.

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Factors influencing…
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The situation
Urgency of results and time pressures.
Magnitude and importance
Structure, uncertainty and risk
Cost-benefit
The environment
External
Internal

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 28

Thank you
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