Decision Making
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The document discusses decision making in nursing administration. It defines decision making and differentiates it from problem solving. It describes various types of decisions including mechanistic, analytical, judgmental, and adaptive decisions. It also discusses models of decision making such as the descriptive model, bounded rationality model, and normative model. Finally, it outlines steps in the decision making process and factors that influence decision making for nurses.
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Decision Making
- 1. DECISION MAKING PRESENTED BY: Ms. Haranjan Kaur M Sc. (N),2nd year Critical Care Nursing CON, DMC&Hospital GUIDED BY: Mrs. Sandeep Saini Prof. CHN, CON, DMC& Hospital
- 2. DEFINITION • Decision making is a complex, cognitive process often defined as choosing a particular course of action. - Webster’s • Decision making is a necessary component of leadership, power, influence, authority and delegations. -John 1993
- 3. DEFINITION (contd..) • Decision making as a systematic, sequential process of choosing among alternatives & putting the choice to action. -Lancaster & Lancaster • Decision making is a conscious, intellectual activity involving judgement, evaluation and selection from among several alternatives. . -Claude
- 4. DEFINITION (contd..) • Problem solving- Problem solving is a part of decision making. A systematic process that focuses on analyzing a difficult situation, problem solving always includes a decision making step.
- 5. DIFFERENCE BETWEEN PROBLEM SOLVING & DECISION MAKING • Decision making can occur without the full analysis required in problem solving. • Problem solving attempts to identify the root problem in situations, much time & energy is spent on identifying the real problem. • Decision making, on the other hand, is usually triggered by a problem but is often handled in a manner that does not eliminate the problem.
- 6. TYPES OF DECISION… Mechanistic decision Analytical Decision Judgmental Decision Adaptive Decision
- 7. Mechanistic Decision • routine & repetitive in nature. • usually occurs in situation involving a limited number of decisions variables where the outcome of each alternative is known. • solves problems by habitual responses. • useful in daily routine & scheduled activities. • Tools used for these kinds of decisions are charts, list, decision tree etc.
- 8. Analytical Decision • This decision helps to solve complex problems. • It involves a problem with a large number of decision variables, where the outcome of each decision alternative can be computed.
- 9. Judgmental Decision • It involves a problem with a limited number of decision variables, but the outcomes of decision alternatives are unknown. • It is useful in marketing, investment & to solve personal problems.
- 10. Adaptive Decisions • It involve a problem with a large number of decision variables, where outcomes are not predictable. • Such ill structured problems require contribution of many people with diverse technical background. Eg. Research finding.
- 11. Nursing Administration Decision Making a. Non routine decision: made by directors of nursing. The outcome of the problem will be unpredictable. Eg. Changing ways of organizing for the delivery of nursing care. b. Routine Decision: made by mid level and low level managers the outcome will be predictable. Eg. Assigning the duty roster, assign the security laws.
- 12. Decisions: Categories • Routine Decisions: Involve no extraordinary judgement, analysis and authority, since they are dealing with less important problems. Routine decisions demand power to select the shortest path, within the given means and ends. • Strategic Decisions: Aim at determining or changing the means and ends of the enterprise. They require a thorough study, analysis and reflective thinking on the part of administrators. Strategic decisions : taken by top managers, Routine decisions: by lower level managers.
- 13. Decision Strategies A strategy is an artful or clever plan for applying techniques to achieve any goal. Before selecting any method of decision making, manager should adopt a decision strategy: Optimizing: in this, an individual analyses a problem, determines desired outcomes, identifies possible solutions, predicts the consequences of each action, and selects the course that yields the greatest amount of preferred outcomes.
- 14. Decision Strategies Cont…… Satisfying: it is in this approach, whereby an individual chooses a problem solutions, and then select best of remaining options.
- 15. Decision Strategies Cont…… Mixed Scanning: making a decision that satisfies to remove least promising solutions, then select best of remaining options. Opportunistic: making a decision for the solution chosen by problem identifier. Do nothing: Taking decision after waiting the storm to pass. Eliminate Critical Limiting Factors: by removing most powerful obstacle to success.
- 16. Decision Strategies Cont…… Maxima: an optimistic approach in which the individual chooses that action alternative that will provide the maximum output. Mini regret: an approach designed to minimize the surprise resulting from any action decision by selecting the action alternative that will provide a result midway between the most desired & the least desired outcomes.
- 17. Decision Strategies Cont…… Precautionary: By choosing action that will maximize gain or minimize loss regardless of opponent's actions. It is useful when the manager engages in a zero sum conflict with another. Evolutionary: individual has to make series of small changes leading towards goal. It is based on the assumption that subordinates can better adjust to a series of small changes than a quantum leap.
- 18. Decision Strategies Cont…… Chameleon: Taking a decision by making a vague plan, adjusted to changing circumstances. It consists of framing management decisions in general terms, so that they can be interpreted differently at different times.
- 19. Basis/Aids for Decision Making Experience Authority Facts Intuition Research and analysis Experimentation
- 20. Factors affecting Decision Making Internal factors • Decision makers physical and emotional status • Personal characteristics and values • Past experience and interest • Knowledge and attitude • Self awareness and courage • Energy and creativity • Resistance to change • Sensitivity and flexibility External factors • Cultural env. • Philosphical env. • Social background • Time • Poor communication • Cooperation • Coordination
- 21. Steps in Decision Making 1. Making the diagnosis 2. Analysing the problem 3.Searching alternative solutions 4. Selecting best possible solution 5. Putting the decision into effect 6. Following up the decision
- 22. 1. Making the diagnosis • First step is to determine what the real problem is?. • If the problem is not ascertained correctly at the beginning, money and effort spent on the decision making will be a waste. The original situation will not come under control. But new problems will start from this incorrect appraisal of the situation.
- 23. 2. Analysing the problem • Done to find out adequate background information and data relating to the situation. • This analysis may provide the manager with some revealing circumstances that will help him to gain an insight into the problem. • The whole approach should be based around the important factors. Only pertinent and closely connected factors are selected, as dictated by the principle of the limiting or strategic factor.
- 25. 4. Selecting best possible solution • Select one of the best course of action among the several alternatives developed; • requires an ability to draw distinctions between tangible and intangible factors as well as facts and guesses. • Instead of picking the best solution managers have to really on a course of action that is satisfactory enough under the existing circumstances and limitations.
- 26. 5. Putting the decision into effect • Decisions can be made effective through the action of other people. • In order to overcome the opposing on the part of employee’s managers can make 3 important preparations. a. Communication of decisions b. Securing employee acceptance c. The timing of decisions
- 27. 6. Following up the decision • As a safe guard against the incorrect decisions managers are required to maintain a system of follow up care of the decisions, so as to modify the at the earliest.
- 29. MODELS OF DECISION MAKING • Descriptive model • Econological model or economic man • Bounded rationality model or administrative man • The normative model • The decision tree model • Simplicity favorite model or view of Games man • The strategic model • Optimizing model • Satisfying model
- 30. Descriptive model Simon developed the descriptive model based on the assumption that the decision maker is a rational person looking for acceptable solutions based on known information.
- 31. STEPS IN DESCRIPTIVE MODEL INCLUDE…. 1.Establish acceptable goal. 2.Define subjective perceptions of the problem 3.Identify acceptable alternatives 4.Evaluate each alternative 5.Select alternative 6.Implement decision. 7.Follow up
- 32. ECONOLOGICAL MODEL It is an ideal view of ‘economic man’, in which the manager is faced with a problem weights the economic aspects of all possible courses of action & chooses the action that is giving greatest net gain or the least loss.
- 33. ECONOLOGICAL MODEL Cont….. Discover Symptoms Set goals or develop criterion define problem Develop alternatives Determine Select alternatives all outcomes act or implement decision
- 34. BOUNDED RATIONALITY MODEL It is the pragmatic view of ‘Administrative man’. In this the people seek a king of bounded or limited rationality in decisions. It has 3 mechanisms as given below: 1) Sequential attention to alternatives: here, persons examine possible solution of a problem sequentially, i.e. if first solution fails to work it is discarded & next solution is considered till he gets acceptable solutions & discontinued after acceptable ones.
- 35. BOUNDED RATIONALITY MODEL cont……….. 2) Heuristics: A heuristic is a rule which guides the search for alternatives into areas that have a high probability for yielding satisfactory solutions. Accordingly, the decision makers use heuristics to reduce large problems to manageable proportions, so that the decision can be made rapidly. They look for obvious solutions or previous solutions that worked in similar situations.
- 36. BOUNDED RATIONALITY MODEL cont……….. 3) Satisfy: This model sees decision maker in a satisficer. Where an alternative is satisfactory if: a) There exists a set of criteria that describes minimally satisfactory alternatives b) The alternative in question meets or exceeds all these criteria.
- 37. Normative Model • At least 200 years old. It is assumed to maximize satisfaction and fulfills the “perfect knowledge assumption” that” in any given situation calling for a decision, all possible choices and the consequences and potential outcome of each are known.”
- 38. 7 steps of Normative Model Define and analyze the problem Identify all available alternatives Evaluate the pros and cons of each alternative Rank the alternatives Select the alternative that maximizes satisfaction Implement Follow up
- 39. Decision Tree Decision point 1 A1 A2 A3 A4 Alternatives Chance events Probable consequences
- 40. Tools of Decision Making • Judgemental technique • Operational research technique • Delphi technique • Decision tree
- 41. Advantages of Decision Making It is Characterized by order and direction that enables managers to determine where they are. Provide framework data gathering which is relevant to the decision. Allows application of previous knowledge and experience that minimize errors and improve quality of patient care and work of an organization. Increase manager’s confidence and ability in making decisions.
- 42. Pitfalls of decision making • Inadequate fact finding • Time constraints • Poor communication • Failing to systematically follow the steps of the decision making process
- 43. Improving Decision Making • Educating people so they know how to make decision • Securing support of top management for decision making at the lowest possible level • Establishing decision making check points with appropriate time limits • Keeping informed of progress by ensuring access to first hand information • Using statistical analysis when possible to pinpoint problems for solution • Staying open to use of new ideas or technologies in analyzing problems& identifying alternatives.
- 44. Strategies in decision making & policy development • Decentralization to the unit level • Committee systems- Opportunity is provided for nurse participation on inter-departmental, interdisciplinary & institution-wide committees with knowledge that collectively made decisions are more apt to be collectively implemented & supported.
- 45. Strategies in decision making & policy development (contd…) • Governance systems- The theory of participative management could be operationalized as management by committees instead of by nurse managers. • Each committee has coordination responsibilities for specific management tasks. This system requires voluntary support & respect for the clinical management role of peers & places control of nursing practice in the hands of professional nurses.
- 46. Individual variations in decision making • Values & decision making-Individual decisions are based on each person’s value system. Values also determine which problems in one’s personal or professional life will be addressed or ignored.
- 47. Individual variations in decision making(contd…) • Life experiences & decision making-Each person brings to the decision making task past experiences that include education & decision making experience.The more mature the person & the broader his or her background,the more alternatives they can identify.
- 48. Individual variations in decision making(contd..) • Individual preference & decision making- Physical, economic & emotional risks & time & energy expenditures are types of personal risk & costs involved indecision making. • Individual ways of thinking & decision making- Evaluating information & alternatives to arrive at a decision is a thinking skill. Individuals think differently. The way one thinks has much to do with individual problem solving & decision making
- 49. Decision making in Nursing As heath care becomes increasingly customer oriented, nurses are responding by establishing close patient care advocated relationships. Sound decision making is the foundation needed to advance professional practice. The decision maker must: a) Assess the situation b) Plan the process c) Implement the decision d) Evaluate the outcome of the decision
- 50. Summary & conclusion…. • Decision making & problem solving occur concurrently with all major functions of nursing management. While problem solving is not the exact equivalent of decision making, it employs a similar thinking process. Decision making is different from problem solving in that the objective does not have to pertain to a problem. It can be an objective that relates to change, to progress, to research,& to implementation of any operational or management plan .
- 51. THANK YOU…..