CHAPTER FIVE

DECISION MAKING
 Objectives:

• At the end of this chapter, the student should

be able to:
1. Describe the types of decisions
2. Explain the mechanisms of decision-making
3. Discuss the steps of logical decision-making
4. Identify the factors responsible for decision-
making
 Cont:
5. Discuss the importance of decision making for
nurse managers?
6. Recognize the decision-making tools
7. Explain the barriers for decision-making and
mechanisms of overcoming it
 Decision making-is
• Decision making-is a choice made between
two or more alternatives. It is choosing the
best alternative to reach the predetermined
objective. Thus decision making is a process
of identifying and selecting a course of action
to solve specific problem.
 Types of decisions

• Decisions made in the nursing service can be

categorized depending upon the following criteria
• How much time the manager spends in making
decision
• What proportion of the organization must be
involved in making decision
• The organization function/ the nursing/midwifery
functions on which they focus
 Cont:
• The following are the main types of decisions
every organization need to take:
• Programmed and non-programmed decisions
• Routine and strategic decisions
• Tactical (Policy) and operational decisions
• Organisational and personal decisions
• Major and minor decisions
• Individual and group decisions
 Cont:
• On the basis of these there are three
classifications:
• 1. Ends -Means
• 2. Administrative-Operational
• 3. Programmed-Non-programmed
• 1. Ends-Means
• Ends: deals with the determination of desired
individual or organizational results to be achieved
 Cont:
• Means: decisions deal with strategic or
operational programmes, activities that will
accomplish desired results. These usually
occur during managerial planning processes,
strategy and objective formulation processes
 Cont:
• 2. Administrative-Operational :
Administrative: made by senior management,
which have significant impact throughout the
organization. Usually this type of decision is
concerned with policy, resource allocation and
utilization.
 cont:
• 3. Programmed-Non –programmed
Programmed-these are repetitive and routine in
nature. Since they can be programmed,
procedures, rules and often manuals are
formulated to cover those situations None
programmed: unique and non- routine
 Conditions that initiate decision making

• 1. Opportunity/threat
• 2. Crisis
• 3. Deviation
• 4. Improvement
 Ways of Decision Making

1. Relying on tradition: taking the same decisions

that had been undertaken when similar problem
arouse in the past
2. May appeal to authority and make decisions
based on suggestions from an expert/a higher
level management
3. Priori reasoning: based on assumption
4. Logical decision making: is a rational, intelligent
and systematic approach to decision making
 Steps of logical Decision Making

• 1. Investigating the situation

• Define the problem
• Identify the problem objective
• Diagnose the cause
• 2. Develop alternatives
• 3. Evaluate alternatives
• 4. Implement and follow up
 Factors Influencing Decision Making

• 1. Decision makers attribute

• Knowledge, experience, and judgment
• Perception and personality
• 2. The Situation
• Urgency of solution and time pressures
• Magnitude and importance
• Structure and uncertainty and risk
• Cost benefit
 Cont:
• 3. Environmental Constraints
• External
• Internal
 Implications for Nurse Managers

• The activities of the problem solver, the nature

of the situation and the environmental
constraints influence how decision is done;
resource spent in performing it, and the quality
of the ultimate decision. However, these
influences are not mutually exclusive.
Managers should recognize these attributes
and be sensitive to the factors that affect
decision-making,
 Encouraging creativity

• Convergent thinking-the problem isdivided

into smaller and smaller pieces to find a more
manageable perspective.
• Divergent thinking: One's view of the
problem is expanded. The problem is
considered in different ways
 Cont:
• Brain storming: under favorable
circumstances a group working together can
identify more ideas than an individual or the
group of individuals working separately. It is a
technique managers can use to create a free
flow of ideas
 Deciding to decide
• 1. Is the problem easy to deal with
• Tip: avoid being bogged down in trivial
details. Effective managers reserve decision
making techniques for problems that require
them.
• 2. Might the problem resolve itself
• Tip: prioritize and rank problems in order of
importance
 Cont:
• 3. Is it my decision
• Tip: the closer to the origin of the problem the
decision is the better. Before deciding ask the
following questions:
• Does the issue affect other departments?
• • Will it have a major impact on the superior's
area of responsibility?
• Does it need further information from higher
level?
 Barriers to Effect Decision-Making

• 1. Easy recall: the more easily can recall the

event, the more frequently they believe it
occur
• 2. Easy search: not to put effort to seek
information from the appropriate sources
• 3. Misconception of chance: Most people do
not understand the nature of random events
 Cont:
• Overcoming barriers to individual problem
solving
• 1. Setting priority
• 2. Acquiring relevant information
• 3. Proceeding methodically and carefully