Mintzberg (1990) identified ten key roles of managers, four of which, that is entrepreneur, disturbance

handler, resource allocator and negotiator are group as ‘decisional roles.’

What is decision-making and what is problem-solving?

Decision-making in relation to care delivery is a function of all healthcare practitioners involved in

patient care by sheer virtue of their contract of employment and their professional body’s code of
professional practice. For the more junior healthcare practitioner, the decision might be when to report
a patient observation to the doctor, for instance; and for a more senior health care practitioner this may
involve deciding at which point to increase the dose of a particular medication.

Decision-making entails considering several components of the situation and ultimately selecting one
specific course of action.

It requires accessing and collecting appropriate facts which led to the final action.

An open mind is often needed which allows a total evidence, previous experience and the use of
professional judgement.

The notion of problem-solving is different in that there is clearly a problem involved or that something is
about to go wrong, and that some action needs to be take resolve or avert it. A decision-making
situation does not always include a problem. Nonetheless, the two notions tend to be treated jointly
and even used interchangeably. However, there are distinctions between the two terms as illustrated.

Distinction between decision-making and problem-solving

Problem-solving
Involves diagnosing a problem and solving it
through a set of decisions
May entail one or more correct solutions
Decision-making
May not involve a problem, as a number of
decisions are made routinely without seeing
them as problems.
Always involves selecting one specific decision
and related actions.
Often decision-making is a subset of problem-
solving i.e. decisions are made on how to solve or
avert the problem.

Ethical decision-making

Another consideration in decision-making is ethical decision-making, in which the five basic ethical
principles, namely the value of life, goodness and rightness, justice and fairness, truth telling and
honesty, and individual freedom need to be heeded. These concepts are examined in most books (e.g.
Singleton and McLaren, 1995; Thiroux and Krasemann, 2007) on healthcare ethics, and they explain in
detail how these principles apply. Briefly they mean:
The value of life Refers to enhancing patient’s health and well-
being
Goodness and rightness Refers to actions that are socially seen as doing
good, and what is right, for those in their care
Justice and fairness Being fair and just towards all patients and
ensuring that they are justly protected from
incompetent practice
Truth telling and honesty Ensuring correct practices are transparently
transmitted
Individual freedom Promoting choice