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Decision makingdecentralization basic goals of decentralization

Decision making is the most important function of all administrators. It is a challenge as well as a risky procedure. Most of the functions of a hospital or any firm requires decision making. As nurses are part and parcel of the administration at various, we must be aware of the challenges, steps and modern techniques of decision making. Effective decision making is an art. It involves finding and selecting the best alternative and having the most appropriate person to make and implement the decision at the right time. Decision making is the process of selecting one course of action from alternatives. It is a scientific problem solving process. Problem solving is a skill that can be learned. Hospital agency may provide policies that may help in taking decision at the staff nurse level, in routine situations. But the nursing administrators are often confronted with challenging situations.



1. Decision making: a purposeful and goal directed effort using a systematic process to choose among options. The hallmark of decision making is the identification and selection of options. 2. Decentralization: is a delegating decision making responsibility to the ones doing the work participatory management. 3. Centralization: is the extent to which authority is retained at the top of the organization. 4. Authority: Power to give orders and make others obey. 5. Delegation: is the process of assigning work from one organizational level to another or from the superior to the subordinate.

Specific objective: After completion of the class. 8.III. 4. Explain the steps in decision making. 12. Discus the basic goal of decentralization. the group will be able to1. List the advantages and disadvantages of decentralization . Discuss the time and basis for decision making. 7. List the types of decision making. Discuss the models of decision making. 13. Define decision making 2. Explain the tool of decision making. 9. Explain the classification and level of decision making. State the factor affecting decision making. 6. OBJECTIVE General objective: On completion of the class the group will have in depth knowledge regarding the decision making. List the decision making authorities. 3. Define decentralization. State the advantages of decision making. 5. Explain the decentralized structure. 10. 11.decentralization basic goal of decentralization and apply it in their practice. 14.

TYPES OF DECISION MAKING 1. list. There are 4 managerial decisions a. • Tools used for these kinds of decisions are charts. CONTENT DEFINITION OF DECISION MAKING • Decision making is a necessary component of leadership. authority and delegations. Rebecca Samson • Decision making is a systematic process of choosing among alternatives and putting the choice in to action. Lancaster and Lancaster Decision making is the heart of all managerial and administrative functions.IV. power. Analytical decision • This decision helps to solve the complex problems . b. influence. Mechanistic • Routine and repetitive in nature • It usually occurs in a situation involving a limited number of decision variables where the outcome of each alternative is known. decision tree etc. John 1993 • Decision making calls for systematic process in which a manager chooses among the alternatives come to a conclusion and select an action. It is the last step of process by which an individual chooses one alternatives from several to achieve a desired objective. It is true that the decision making is a part of everyday life. Decision making is at the core of all planned activities.

Important. • Computational techniques involve linear programming and statistical analysis. c. Eg. b. assign the security laws. d. • Such ill structured problems require contribution of many people with diverse technical background. Non routine decision: made by directors of nursing. Eg.• It involves a problem with a large number of decision variables where the outcome of each decision alternatives can be computed. • These types of decision are useful in marketing investment and to solve the personal problems. CLASSIFICATION OF DECISIONS & LEVELS OF DECISION MAKING Generally decisions are broadly divided into two categories: 1. vital or strategic decisions . Adaptive decision • Decisions involving a problem with a large number of decision variables where outcomes are not predictable. Routine decision: made by mid level and low level managers. Judgemental decision • Decision involves a problem with a limited number of decision variables but the out of the decision alternatives are unknown. The out of the problem will be unpredictable. routine. Nursing Administration decision making According to Ann Bill Taylor a. unimportant decisions 2. Typical. Research finding 2. Changing ways of organizing for the delivery of nursing care. Eg. Assigning the duty roster. the outcome will be predictable.

It includes guess work. since they are dealing with less important problems. Strategic decisions: Aim at determining or changing the means and ends of the enterprise. while routine decisions are made mostly by lower level managers. They require a thorough study. 2.Routine decisions: Involve no extraordinary judgement. 3. facts. 5. analysis and experimentation. Strategic decisions are usually taken by top managers. authority. Experience gives the administrator the requisite vision. 4. TIME AND BASIS FOR DECISION MAKING There are six important bases for decision making which are referred to as aids to decision making and they include experience. Since experimentation becomes and expensive basis for . and common sense views. research. Research and analysis: These are the most effective basis for choosing among alternatives. 1. Authority: Provides an important basis for enabling managers to take quick and sound decisions. analysis and reflective thinking on the part of administrators. 6. The computer technology has been introduced for supplying greater facts to operating managers. Routine decisions demand power to select the shortest path. analysis and authority. intuition. within the given means and ends. Experimentation: This provides another means by which various alternatives can be evaluated. Decisions become wrong only when adequate facts are not available on the problem. Experience: Experience is the most important and valued basis for making decisions. Intuition: It is the residuary basis for covering up deficiencies in other three bases of decision making. Facts: Provide the solid basis for decision making. It helps in finding out relationships among the other important variables. that trains him to apply his knowledge to the best of its use and that helps him to recognize the crucial factors from unnecessary details.

introduction of new organizational technique etc. product development.decision making in many cases. it is used sparingly for indicating the best course of actions in problems like policy formation. FACTOR 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 environment • Philosophical environment • Social back ground • Time • Poor communication • Cooperation • Coordination STEPS IN DECISION MAKING .

Selecting best possible solution . In the absence of alternatives decision making process will become. Searching alternative solution After anodizing the problem attempts are made to find alternative solutions to the problem. Following up the decision Making the diagnosis The first step is to determine what the real problem is. The diagnosis should not be merely based on one or two visible symptoms. The original situation will not come under control.The decision making task can be dividing making into six steps which are stated in order of their sequence as: 1. as dictated by the principle of the limiting or strategic factor. Only pertinent and closely connected factors are selected. Making the diagnosis 2. money and effort spent on the decision making will be a waste. The whole approach should be based around the important factors. This analysis may provide the manager with some revealing circumstances that will help him to gain an insight into the problem. Putting the decision into effect 6. Selecting best possible solution 5. Analysing the problem 3. If the problem is not ascertained correctly at the beginning. But new problems will start from this incorrect appraisal of the situation. Analysing the problem The problem should be thoroughly analysed to find out adequate background information and data relating to the situation. Searching alternative solutions 4. But it should be diagnosed after the analysis of the whole situation.

Committees Individuals as decision makers . Individual 2. Securing employee acceptance c.Selection of one best course of action among the several alternatives developed. a. Group 3. The time considerations that meet the needs of the situation. The timing of decisions Follow up the decision As a safe guard against the incorrect decisions managers are required to a system of follow up care of the decisions so as to modify them at the earliest. Putting the decision in to effort The decisions can be made effective through the action of other people. 3. 2. DECISION MAKING AUTHORITIES 1. The four criteria have been suggested by Dracker in selecting the best solution. 4. Relevance between the economy of effort and the possibility of results. The limitation of recourses. 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. 1. Communication of decisions b. require an ability to draw distinctions between tangible and intangible factors as well as facts and guesses. In order to overcome the opposing on the part of employee’s managers can make three important preparations. Proportion of risk to the expected gain.

Commitment to the decision and to the implementation is important and may be increased by participation in the decision making process. Advantages of group participation • Increasing self expression. • Perception of the problem: it is affected by ones previous experience and value system. Disadvantages of group participation • Change in the participants may create problems. good or desirable. • Personal value system: basic convictions about what is right. innovation and development. There are mainly 3 behavioural characteristics that influence the decision making. • Few people may dominate in the group. Committee Aspects in Decision Making . • Increases the commitment. less effective and represents a threat to his/ her position. • The decisions can be most acceptable but not optional.The autocratic manager’s fears that decisions made by others may be more costly. • The role theory: it predicts how actions will be performed in certain roles and how it will be affected certain circumstances. Group factors in decision making Group comprises two or more people who share common interest and come together to accomplish an activity through face to face interaction. Specific behaviour associated with position constitutes roles. • Members may become more interested in arguments and winning than finding a solution.

. the problem is structured or routine. • Pressure for unanimity discourages creativity from the members. It is used when information is objective. AII – obtain necessary information from your subordinates then decide on a solution to your problem. But subordinates will be unaware about the problem. MODELS OF DECISION MAKING Vroan and Yelton Narrative/Prescriptive Model They define decision making as a social process and emphasis how mangers work rather than should behave in their normative way. and options are known and predictable. It can be formal of informal committee. A committee appointed to collect data analyze finding make recommendations is an ‘ad hoc committee’.A committee a group of people chosen to deal with a particular topic or problem. It is used when information is rather than should behave in their normative way. A – Autocratic C – Consultative G – Group I – First variant II – Second variant AI – making decision by yourself using information available to you at that time. Vroan and Yelton identified 5 alternative decision making process. Advantages of decision making by committee • Time consuming • Expensive • Indecisiveness can be result in the adjournment of the committee.

• The acceptance rule: If the acceptance of the decision by the subordinates is critical for the effective implementation. CII. and CI. if it is uncertain that an autocratic decision made by the leader would receives the acceptance then AI. AII.CI . • The information rule: If the quality of decision is important and the leader doesn’t poses adequate information to solve the problem then AI is eliminated from the feasible set. You do not try to influence the group to adopt your solutions but are willing to accept and to implement any solution that has the support of the entire topic. • The unstructured problem rule: If the quality of decision is important and the leader doesn’t poses adequate information to solve the problem and if the problem is unstructured then eliminate AI. AII are eliminated from the feasible set. AII. Three rules protect the decision and quality and four rules protect the acceptance. • The conflict rule: if the acceptance of the decision is critical and if it is uncertain that an autocratic decision made by the leader would receives the acceptance and subordinates are likely to be in conflict over the appropriate solution then AI. CI is eliminated from the feasible set. and gets their ideas and suggestions. Then you make a decision that may or may not reflect your subordinates influence.shares the problem with subordinates share the problem with subordinates as a group. together you generate and evaluate alternatives and attempt to reach agreement on a solution. Vroan identified 7 rules that do most of the work of the model. . GI – is applicable only in more comprehensive models. • The goal congruence rule: if the quality of decision is important and the subordinates do not share the organizational goals to be obtained in solving the problem then GII is eliminated.

AI. This process is most expedient and may be the most appropriate when time is an issue. It is more conservative method compared to an optimizing approach. CI and CII are eliminated. etc. TOOL OF DECISION MAKING 1. Descriptive or Behavioural Model Used when information is subjective. Delphi technique 4. • The acceptance priority rule: if acceptance is critical. acceptance is critical. Optimizing Model Decision maker select the solution that maximally meet the objective for a decision. This process is most expedient and may be the most appropriate when time is an issue. not assured by an autocratic decision and if subordinates can be trusted then AI. non routine or unstructured. Uncertainty exists because outcomes are unpredictable. CI. Operational research technique 3. and an uncertain to result from an autocratic decision. The goal is to select the most ideal solution. Judgmental technique . Satisfying Model Decision maker selects the solution that minimally meets the objective for a decision. AII. Decision tree 1. employing creative approaches. Situational that fall in to this category can be better handled by gathering more data. using past experience.• The fairness rule: if the quality of the decision is unimportant. Judgemental technique 2. Usually this process involves assessing the pros and cons of each known outcomes as well as listing benefits and costs associated with each option. AII. and CII are eliminate.

This technique is based on the assumption that a linear relationship exists between the variables and the limits of variation can be calculated. Three conditions must be existing before linear programming must be utilized. b) Steps of OR technique • Construction of mathematical model that pinpoints the important factor in the situation. • Procuring empirical estimates of the numerical parameters in the model that specify that particular situation to which it is applied.a) This is the oldest technique and subjective in decision making. Linear programming: Uses linear mathematical equations to determine the best way to use limited resources to achieve maximum results. a) Operational research makes the decision analytic. f) Rarely used in large capital commitments. e) Hazardous due to a chance for taking wrong decision. Types of OR Technique 1. . c) Useful in making routine decision. 2. Linear programming is a sophisticated short cut technique in which computers can be used. objective and quantitative based. • Carrying out through the mathematical process of finding and series of action which will give optimal solution. d) Cheap and not time consuming. Operational research technique (OR) It can be defined as the analysis of decision problem using scientific method to provide manager the needed quantitative information in making decision. • Definition of criteria to be used for comparing the relative merits of various possible courses of action. b) Based on past experience and intuition about future.

and instructors in school of nursing. d) Use of recourses can be considered when setting priorities. each player or group of player tries to choose a course of action which will frustrate opponent’s action and help in winning the game. It involves identifying the key activates in a project. . c. a) It is appropriate for project work that involves extensive research and development. Either a maximal or a minimal value is sought to optimize the objective. sequencing the activities in a flow diagram. A group of items waiting to receive service is known as a ‘queue’. The same will apply in the context of business by maximize his loss. 4. The ratio of change in one variable to the changes in the other variable must be constant. Queuing theory: It deals with waiting lines or intermittent servicing problems. The value may be expressed in terms of cost or quantity. Constraints to the relationship of the variable exist. f) Overtime or temporary help can be given to facilitate the activity flow. 2. The variables affecting the goal must have a linear relationship. It can be used to determine a minimal cost nutrition diet or determine a class size. and assessing the duration for each phase of work.a. g) Can manipulate the time required to move from one event to another. class hours. e) Assignment can be changes temporarily. By decreasing or eliminating the waiting line to reduce waiting line cost. It balances the cost of waiting versus the prevention of waiting by increasing the services. b. Games theory: In normal games. b) Helps to predict time. 3. Programme evaluation and review technique (PERT): PERT is a network system model for planning and control under certain conditions. there is an increase in cost of labor and physical facilities. c) Helps to determine priorities.

6. supplies and material management system. Little changes usually occur after the second round. policy and procedure changes and announcements. This process continues until the consensus is reached.5. • But it is true consuming. personal records. Again the members are asked for suggestions. the results of the first questionnaire are centrally compiled and sent to each member. 3. staff scheduling. Computers in decision making: In management information system computers can be used for various activities like patient classification system. risk and information needs for a specific problem over a period of time. It helps to see the possible directions that actions may take from each decision point and to evaluate the consequences of a series of decisions. administrative reports and memos etc. The process begins with a primary decision having at least two . statistical reports. Delphi technique It allows members who are dispersed over a geographic area to participate in decision making without meeting face to face. Decision trees A decision tree is a graphic method that can help the supervisor in visualizing the alternatives available. Critical path method calculates a single time estimate for each activity. patient charges. budget information and management. • The Delphi technique is free from others influence. Critical path method (CPM): Closely related to PERT. This is possible through the use of questionnaire. The members will return the questionnaires anonymously. the longest possible time. • Doesn’t require physical presence. • Appropriate for scattered group. CPM is useful where the cost is a significant factor. outcomes. 4.

A1 Decision point 1 A2 A3 A4 Alternatives Chance events ADVANTAGES OF DECISON MAKING 1. control of facilities. 4. 3. . In nursing service. Then the predicted outcome of each decision considered and the need for further decision is contemplated. Departmentalization aims to provide better arrangements. departmentalization aims on attaining a better quality of patient care through benefits derived from specialist nurses. 2. equipments and materials required to perform the necessary service. 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 decision. Provide a frame work data gathering which is relevant to the decision. DECENTRALIZATION Introduction Decentralization is the division of activities by forming departments.alternatives. It is characterized by order and direction that enables managers to determine where they are.

The centralization and decentralization can be thought of as two theoretical extremes of one continuum. Decentralized structure The decentralized structure is flat in nature and organizational power is spread out throughout the structure. Top management needs a positive attitude towards decentralization and they need competent personal to whom they can delegate authority. Decentralization versus Centralization The term centralized and decentralized refer to the degree to which an organization has spread its lines of authority. These are few layers in the reporting structure. The centralization tends to concentrate decision making at the top level of the organization. power. Institution makes use of both centralization & decentralization.The nursing service administrator should explicitly define the standards. Complete centralization complete decentralization Authority decentralization Authority not delegated Definition of decentralization Decentralization is the dispersion or delegation of responsibilities and the authority to lower levels of an organization. policies. and scope of decision to be undertaken by top administration and those to be handled by departments and their subunits. In other words the decentralization is the extent of authority is passed down to lower levels in the organization. The centralization is the extent to which authority is retained at the top of the organization. whereas decentralization disperses decision making and authority throughout decision making and authority throughout and further down the organizational hierarchy. and managers have a broad span of control. and communication. Communication patterns are simplified and Nursing Administrator .

Decentralisation is delegating decision making responsibilities to the ones doing the work participatory management. delegation fosters participation. In doing so. The first line manager does not need to go to his or her department head of the other service. Decentralization refers to the degree of which authority is shifted downward within an organization to its divisions. and units. Both decentralized management and participatory management delegate authority from top managers downward to the people who report to them. A first line manger with delegated authority will contact another department to solve a problem in providing a service. Maternity supervisor Paediatric supervisor Surgery supervisor Nurse Nurse Nurse Nurse Nurse Nurse Dec Decentralization (Flat. Implementation of philosophy of decentralized decision making by top management sets the stage for involving more people perhaps even the entire staff in making decisions at the level at which an action occurs.problems tend to be addressed with ease and efficiency at the level at which they occur. Participatory) Structure Flat organizational structures are characteristic of decentralized management. creating a . In nursing. services. as in other organizations. Employees have autonomy and increased job satisfaction within this type of structure. and accountability. and an obligation or responsibility is created by acceptance the employee is accountable for results. authority is granted. objectives or duties are assigned. Horizontal. teamwork.

Maintenance of uniform policy throughout organization becomes difficult. 7. 6. resulting in efficient and cost effective management. 6. Prepares mangers for rapid change in the organization. 5. Relieves top manager from burden of managing. Limited by inadequate number of qualified personnel at lower level. 7. Encourages subordinates to undertake responsibility. 8.communication bottleneck. 8. More freedom to managers. taxation policy of government. Enhances competition among various departments/units. Increases motivation of subordinates. 3. Increases complexity of coordination. May be constrained by inadequate planning. It may be limited by external factors like. 4. Limitations The limitations of decentralization are as follows: 1. Limited by inadequate training. ADVANTAGES AND LIMITATIONS OF DECENTRALIZATION Advantages The advantages of decentralization are as follows: 1. May lead to loss of control by superior level managers. government regulations. 2. 5. 4. etc. May be limited by inadequate control techniques. The people closest to the problem solve it. 3. 2. Promotes development of general managers. . Helps setting up of profit centres.

Mary Lucita. the trend is towards decentralization. 1999 2.V. It is effective only when it is timely done. BT Basavanthappa. Marquis and Carol J. BIBLIOGRAPHY Text Books 1. VI. Leading and managing in Nursing. 2 nd edition. Petricia S Yoder-Wise. 2 nd edition. It needs courage as well as creative thinking from the part of the nurse administrator. 2006 . 5th edition. Huston. Mosby publication. Nurses should actively involve in decision making in all levels rather than simply obeying the decisions. CONCLUSION Decision making lies deeply embedded in the management process and is the only vehicle for carrying managerial work load. There are distinct advantages of both the systems. New York: Lippincott Williams & Wilkins. New Delhi: Jaypee brothers’ publication. 2007 3. India: Elsevier publication. Management & Leadership for nurse administrators. The size of the organization is also a key factor in determining the extent of centralization or decentralization. Nursing Administration. Linda Roussel. USA: Jones & Bartlett publication. Nursing: Practice and Public Health Administration. 2006 5. Leadership Roles and Management Functions in Nursing – Theory and Application. 2nd edition. 4 th edition. 2009 4. As the scope and amount of work of manager increasers. Bessie L.

2002. Journal/Abstracts Research conducted on Magnet hospitals found the must of the hospitals has a decentralized structure in which nurses had a feeling of control over their unit work environment. Porter O’Grady identified the following conditions as essential for effective decentralization: • Freedom to function effectively • Support from Peers and leaders • Concise and clear expectations of the work environment • Appropriate resources . Russell. Introducdtion to management and leadership for nurse manager. Richard j Swansburg. C Swansburg. USA: Jones and Bartlett publication.6. 3rd edition.