Chapter 1 discussion decision making

Decision making
A complex and cognitive process often defined as choosing a particular course of action
The process of choosing one course of action over another
Decision is a course of action that is consciously chosen from available alternatives for the purpose of achieving a desired result.(Venzon)
Problem solving
O Is a part of decision making
O A systematic process that focuses on analyzing a difficult situation
O It always includes a decision making step
Critical thinking
O Referred to as reflective thinking
O It is related to evaluation and has a broader scope than decision making and problem solving
O Is a manner of thinking that moves from general to specific, ever narrowing the focus until the logic of both the questions and the arguments comes to the same conclusion
Characteristics of critical thinker
Flexible Persistent Creative
Caring open to new ideas Resourceful
Analytical outside the box thinker energetic
Intuitive outcome directed empathetic
Assertive observant willing to take action
Insightful Risk taker willing to change
Communicator knowledgeable

Vicarious Learning to Increase Problem Solving and Decision Making Skills
Case Studies
According to research done by Bowers (2004) concluded that case study learning provided a positive learning experience to promote clinical decision making and judgment in nursing students.
Similarly, simulation models are increasingly being used by schools of nursing to allow the transference of textbook knowledge into a real life situation where nursing students can function in their role without negatively affecting their clients.(Robertson,2006)

Heuristics
It involve being able to recognize patterns and being able to more rapidly solve a problem or come to a conclusion
A way of thinking and solving problems,quickly,effeciently, and maximizing what is already known.
refers to using a trial and error of rules of thumb approach to problem solving
O Fascione (2006)
recognizes the value of heuristics in decision making but warns that heuristics are only short cuts, not fail,safe rules and that relying on heuristics may work most of the time but will not be the best all of the time.

People think illogically in three ways:
1. Overgeneralizing
A type of crooked thinking occurs when one believes that because A has a particular characteristics, every other day has the same characteristics. This kind of thinking is exemplified when stereotypical statements are used to justify arguments and decision.
2. Affirming the consequences
In this type of illogical thinking, one decides that if B is good and he or she is doing A, then A must not be good.
3. Arguing from analogy

Rational and Administrative Decision Making
This thinking applies a component that is present in two separate concepts and then states that because A is present in B, then A and B are alike in all respects.


In the late 1940s, Herbert A. Simon’s work revealed that most managers made many decisions that did not fir the objective rationality theoryHe delineated the two types of management decision makers
1. ECONOMIC MAN
2. ADMINISTRATIVE MAN

Economic
Makes decisions in a very rational manner
Has complete knowledge of the problem or decision situation
Has a complete list of possible alternatives
Has a rational system order of ordering preference of alternatives
Selects the decision that will maximize utility function
Administrative
Makes decisions that are good enough
Because complete knowledge is not possible, knowledge is alwys fragmented
Because consequences of alternatives occur in the future, they are impossible to predict accurately
Usually chooses from among alternatives, not all possible ones
The final choice is satisficing rather maximizing


Clancy (2003) maintains that even the most experienced manager cannot eliminate all uncertainty when making decision. However, to assist manager in making decision, management analysts have developed tools that provide order and direction in obtaining and using information which are helpful in making decision, these are;
Decision Grids
Pay-off tables
Decision Trees
Consequence Table
Logic Model
Program Evaluation and Review Technique

Decision grid
It allows one to visually examine the alternatives and compare each against the same criteria.Although any criteria may be selected, the same criteria are used to analyze each alternative.This tool would be useful when changing the method of managing care on a unit or when selecting a candidate to hire from a large interview pool
Payoff tables
O These have a cost-profit-volume relationship and are very helpful when some quantitative information is available,such as an item’s cost or predicted use.
O To use payoff tables, one must determine probabilities and use historic data e.g., hospital census or report on the number of operating procedure to be performed.

Example:
If Mr. M,the nursing management intstructor for the class costs Php500 , the dean would need to charge each 40 participants Php12.5 for the class, but for 46 participants, the class would cost only Php10.87 each.
The dean would use attendance data from past classes and the number of nurses potentially available to attend to attend the probable class size.
Payoff tables does not guarantee that a correct decision will be made,but they assist in visualizing data
Decision trees
Used to plot a decision over time, decision trees allow visualization of various outcomes
Consequence table
Clancy (2003) used consequence table to demonstrate how various alternatives create different consequences. A consequence table lists the objectives for solving a problem down one side of a table and rates how each alternative would meet the desired objective.
PERT
It is a popular tool to determine the timing of decisions.
Developed by the Booz-Allen-Hamilton organization and the US Navy in connection with the Polaris missile.
a flow chart