Decision Making & Problem solving

Prepared By

Nouran A . Fouad

Supervised By

Dr. Fatma Abed

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Objectives:
[1] [2] [3] Identify problem solving methods.

Identify creative decision making techniques. Discuss ethical aspects of decision making. [4] [5] Identify decision making tools. Discuss decision making process.

Outlines:
Introduction Definitions Problem solving Process Methods Decision making Process Types Characteristics of decision maker Creative decision making - Process -Techniques -Which block creativity Ethical aspects of decision making (3)

Decision making tools. 1 probability theory 2 Simulation models & games 3 Cantt chart 4 Decision trees. 5 Program evaluation & review technique. 6 Critical path method. 7 Linear programming 8 Computers Advantages & disadvantages of quantitative tools.

Methods of teaching:
o o lecture

PowerPoint

References.

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Introduction
Decision making is a continuing responsibility for a nurse manager. Managers are confronted by a variety of situations. Hospital or agency policies provide guidelines for dealing with routine situations. Some times, it is difficult to make a decision that may require mature sense of judgment. Nurse manager should develop effective decision making skills. The successful decision maker is one who is both willing and able to make quality decision. An effective manager must be able to answer certain questions: is a decision required?, how the decision should be made?, & Who should be involved in the decision?

Definitions
Problem solving

A process whereby a dilemma is

indentified & corrected.

Decision making

Is a complex cognitive process often

certain conditions.

defined as choosing an appropriate alternatives & weighed with Creative thinking process emphasizes the uniqueness of the solution

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Problem solving
People use problem solving when they perceive a gab between an existing state & desired state. The scientific problem solving process requires searching for information to clarify the nature of the problem & to discover a variety of solution. These solutions are carefully evaluated & the best is chosen for implementation. The implemented solution is maintained over the time to insure its immediate & continuous effectiveness. If difficulties are encountered some or all of the process is repeated.

Process:
[1]

Define the problem Is the most

the solutions or identifies needed changes. Premature interpretation can alter one's ability to deal with facts objectively.

important part. How the problems are perceived determines

[2]

Gather information That initiate a

solution of the problem. A carful, systematic, complete

search for additional facts that provide clues to the scope & search facilitates the accomplishments of goals & evaluates the possible effect of the solution. [3]

Analyze the information

orderly arrangement, as following:

Should done only when all of it has been sorted into some

a. b. (6)

From most important to least. According time sequence.

c.
[4]

In term of cause & effect.

Develop situations Solutions

developing the best of them. Developing alternative

should be written down & plans made to immediately start solutions makes it possible to combine the best parts of several solutions into a superior one. [5] Make

a decision After reviewing the

list of potential solutions select the one that is most feasible & satisfactory & has the fewest undesirable consequences. [6]

Implement the decision

motivated & has participative management.

Employees should cooperate, fully acceptable & dedicated or

[7]

Evaluate the solutions Review

those of the idealized solution. Periodic checkup give the

the plan instituted & compare the actual results & benefits to nurse manager valuable insight & experience to use in other situations & keeps the problem solving process on course.

Methods of problem solving:

[1] Trail & error methods

Method whereby one

appears to be improving.

solution after another is tried until the problem is solved or [2] [3] [4] Experimentation Self solving

Type in which a theory is

tested to enhance knowledge understanding or prediction.

A problem that if permitted to run a When complexity of the problems

natural course, will be solved by those personality involved. Group solving

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& the staff's desire for meaningful involvement at work

create the impetus for using group approaches to problem solving.

Group Solving advantages:

[1] Possess greater knowledge & information. [2] [3] [4] [5] [6] Deal more complex problems. Likely to try several approaches. approach problem. Generate more complete, accurate & less biased information. Increase likelihood of acceptance & understanding decision. [7] Enhance cooperation in implementation.

Have greater variety of training, experiences &

Group solving disadvantages

[1] Group think; a negative Phenomenon occurring in highly cohesive, isolated group in which group members come to think alike which interferes with critical thinking. [2] [3] Premature concurrence; a result of groupthink caused by pressure to conform, self-censorship & mindguards. Mindguards; Feature of groupthink in which the group is protected from controversial information. [4] [5] Dialectical inquiry ; technique used to minimize groupthink though the use of a formal depate format. Risky shift; A phenomenon seen in group in which riskier, & more controversial decisions are make. [6] [7] Group need more time & resources. group being have power. Produce conflict between group & nurse manager as

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Misperception & illusions; involve a) Ignore ethical & moral consequence of their decisions. b) rationalization of warning & negative feedback. c) Biased perceptions of the out-group.

Decision Making Process:

Decision making relies on scientific problem-solving process:
[1]

Indentify the problem &

analyze the situation The first step in

decision making is defining the problem, whats wrong? Where is improvement needed? It 's most important to define the factors that are causing the problem. [2]

Explore alternatives

There are

usually a number of ways to solve a problem. Some way may be quick & economical but less effective than their alternatives & vice versa. If various alternatives arent explored, the course of action is limited. [3]

Choose the most desirable alternative

The number & quality of

alternatives depend largely on the creativity & productivity of management & their staff. The manager should try to balance factors as patient safety, staff acceptance, morale, public acceptance, cost & risk of failure.

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[4]

Implement the decision

The

decision & procedures for its implementation can be explained to win cooperation. The manager will need select staff for implementation to initiate action. [5]

Evaluate the results Evaluative

criteria may have to be developed, as audits, checklist ,

rating & ranking can be used to review & analyze the results.

Types of decisions:
[1] Routine decisions

Common problems can usually

be solved with routine decisions. E.g., When nurse makes a medication error, manager's action are guided by policy & report from. [2] Adaptive decisions

When both problems &

alternatives solutions are unusual E.g., manager may decide to adapt a negotiating strategy that was successful in a previous. [3] Innovative decisions

When problems are usual &

unclear & when creative, novel solutions are necessary.

Characteristics of decision maker:

[1] [2] [3] [4] [5] Knowledgeable. Open-minded Inner motivated. Mental ability.

Self trust & acceptance.

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[6] [7] [8]

Objectivity

Energy for Complexity all causative factors.

Analytical thinning; ability to analyze situation from [9] Courage; have enjoyment of risk taking.

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Creative Decision Making Phases :

[1] [2] [3] Felt need : When d. maker confronted problem. Preparation : which creative ideas emerge by exploring relationship between potential solutions. Incubation : Period for analyzing situation in situation & review data collected. [4] [5] Illumination : Solution discovery period come at any time to mind. Verification : Period of experimentation when idea is improved through modification. repeating the same thoughts no new ideas to reexamine

Encouraging creativity :
The thinking mechanism of human brain has been conceptualized as having two sides, rt. conceptual & lt. analytical we are usually socialized use lt. side more.

Creative thinking technique:

[1] Brainstorming : Technique use to create free flow of ideas out fear of criticism. This improve quality, provide new combination through rearrangement, substitution & modification. Usefull when group, need mutual respect atmosphere. [2] [3] Divergent : One's view problem in different ways. Convergent thinking : One's break down problem into pieces to be more meaningable.

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[4] [5]

Reverse brainstorming : encourage convergent thinking done verbally. Brain-witting : Encourage recording ideas out

verbal interaction. Participants are given paper & told to least at least four ideas then passed to someone reading. Process is continuous until no one can think of any thing else. [6] [7] Collective notebook technique : As brain-writing but has specified period Forced association : Participant list associated words or variables then critically analyzed to choose useful to addressing solution. [8] Think tanks : Some people are gathered togather from different places to stimulate innovation. Need relaxed atmosphere & clearly goal. Useful for future projections. [9] Stepladder technique : Initially two group members try to solve problem then 3ed member join to present preliminary solutions presentation is discussed by all three persons. The process is repeated group members are add until all members of group have presented & available to participate in final decision. [10] Dolphin technique : Allows members who are scattered geographically to participle in decision making out face to face meeting through questionnaire & sent copy of results after viewing it members are asked for their suggestions again & comparing results. It's cost effective & time consuming. [11] List : Checklist method used to assemble criteria, sort it, prioritize it, eliminate items & add others.

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[12] [13] [14]

Drawing : Used to evoke creative insight in symbols than in words. Synetics : Join apparent irrelevant elements together then simplified to clarify it. Visualization : Create a big dream approach, once how to make your dream a reality thus facilitates concentration on the outcomes.

you have imagined what you want, you can dreaming about

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Forecasting alternative future scenarios : Process constructing possible alternative & identifying preferred future then developing plan of action, implement & evaluating it.

include assessing situation identifying strengths & weakness,

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Self interrogation checklist : Self questions used to assess options, generate new ideas & make decisions.

stimulate new ideas about situation. Help abtain information, [17] [18] Modeling : Look at how others are doing & what you wish to do. Mediation : Generate a more focused state a relaxed attention.

W blocks to creativity ?
[1] [2] [3] Negative attitudes. Self-censorship Lock of confidence. [4] [5] Habits. Conformity.

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Ethical aspect
Is a moral philosophy controlling means so they will serve human ends . The choice of action is influenced by values

[1] [2] [3]

Dentotolgical

Ethical theories:
Which focus on intention of action Which mean that right roles has

choice rather than the end of action. Teleological Principlism

good consequence & bad had bad consequence.

It's moral norms including autonomy

justice, fidelity , utility, beneficence & respect for others. Each principle can be used individually or concert -Autonomy ; involve freedom of choice & responsibility for one's choices.

-Fidelity; this principle can support providing extensive, painful treatment to increase quantity & quality of life. -Justice; One shouldn't make a promise to a patient or worker that can't be kept. -Respect for others; Considered acknowledge the rights of people to make their own decisions. -Utility; indicate that what's best for the individual.

Decision making tools:

[1] Probability theory

applied when risk or

uncertainty is present in a decisions, can be used to predict results. There are three criteria that assume that;

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a)

Maximax criterion manager

determine factors influencing their decision & select the option from which they can achieve the best results. This is dangerous criterion in that it doesn't consider possible complications. b)

Maximin criterion Manager expect

the worst possible results. They consider that complication can occur for each option & select the

alternative that offers the best result when everything possible goes wrong. c)

Minimax criterion Where something

unexpected prevented them from achieving most favorable results, manager then try to minimize & subtract complication.

[2]

Simulation, Models & Games

Simulation is way

of using model & game to simplify problem by identifying the basic components & using trial to determine a solution. Through simulation manager can compare alternatives & their consequences. A model represents objects, events, processes or systems for studying something under varying conditions. Low cost compared with real occurrence. [3] Gantt chart

Are highly schedule developed to

allow visualize multiple tasks that have to be done within specific time. Usually typed on computer.

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Decision tress :

A1 A2 A3 D P e o c is i o
Al te rn at

i n

n A4
s

Tree graphic method can help manager visualize the alternatives available, outcomes, risks & information needs. It help them to see the possible directions & to evaluate the consequences.
[5] Program evaluation & review technique (PERT) Is a network system model, involve identifying the key of the work. PERT recognize that certain task should be completed before other the key events are identified, numbered & labeled on the flow chart which have arrows indicate direction of work flow. PERT model help manager to determine priorities, use resources can be considered, Assignment may be changed, over time may be allowed to facilitate the activity flow & to manipulate the time require to move from one event to another. [6] Critical path method

iv e

e e n v ce en P e r t os b

l e

c o

activities in a project, assigning. The duration of each phase

Closely related to PERT

with estimation of cost & time for each activity through normal & crash operating conditions. Normal mean the least cost method & crash refer to conditions in less than normal

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time. CPM is particular useful where cost is a significant factor. [7] Linear programming

uses linear mathematical

equations to determine the best way to use limited resources to achieve the maximal results. Three conditions are necessary 1st maximal or minimal values to optimize the objective as cost, time or quantity. 2nd variables affecting the goal. 3ed constricts to the relationships at the variables. Variables used with presence of restrictions so wouldn't be need the linear programming if there were no restrictions. [8] Computers

Provide several advantages; stored in & efficient.

small areas, search & analytical tasks can be performed fast

Advantages & disadvantages of quatitivae tools:

Advantages:
[1] [2] [3] [4] [5] Rational

Systematic approach

Expressed mathematically Encourage disciplined thinking

Evaluate thousands of interrelationships.

Limitations:
[1] No measurable factors that reduce the effectiveness of the tool. [2] The mathematical expressions are based on useless. assumptions: if those assumptions aren't true the tool become

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References

Marquis, B., & Huston (1994) Management Decision Making for nurses. Lippincott Co., Sullivan, E. & Decker, P. (1997) Effective leadership & management in nursing Addison wesly longmen company 4th ed. Tomey, A. (1996) Nursing Management & leadership Mosby Co., 6th ed.

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