Decision Making Case Study

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Decision Making Case Study
Nadine Ranger Week 3
HCS/514
August 23, 2010
Sara Brown

Decision-Making Case Study
Effective decision-making is a major component in managing an organization, resources, and staff members.   Managers make important decisions daily that affect the operations, quality, and success of their organization.  Instituting evidence informed decision-making is a growing concept among health care organizations, but managers face several challenges including time pressures and lack of resources to determine quality information. The use of adequate decision-making tools and resources help managers make strategically important decisions as well as develop and improve their decision-making skills. To effectively the best recourse in the following case study, the manager describes the best tool for deciding what services to improve or eliminate and how the tool affects accountability, knowledge transfer, and a questioning organization.

Case Study
The manager will use the tools in the informed decision toolbox developed in 2007 by Rundall et al. to best decision for the county clinic providing care for Medicaid clients. The scenario in this case study involves a county clinic in which the budget has been cut by 15%.   This clinic provides care to Medicaid clients and the challenge to management is to identify the clinical services that should be eliminated or introduced to best address the health care needs of the clients.   The manager must determine the best tool to use to make these decisions and the rationale using it.

Starting the Decision-making Process
    With rising health care costs and the current state of the economy, it is not surprising that the clinic is forced to reduce its budget.   The organization has decided to finalize the budget cuts, and decisions must be made about how to best achieve the goal of reorganizing services and maintain the level of care it currently provides to their Medicaid clients.   Rundall et al., (2007), describes a decision-making process and set of tools that may help the clinic make the most informed and effective choices to determine which services should be changed to meet the budgetary constraints (Rundall et al., 2007).

The Toolbox
Rundall et al. developed a tool they call the Informed Decisions Toolbox or IDT, which they suggest will help make better evidence-informed management decisions.   Evidence-informed decision-making is the process of gathering and analyzing the best evidence available and making an informed decision based on that knowledge (National Collaborating Centre for Methods and Tools [NCCMT], n.d.).

The process of evidence-informed decision-making involves six steps.   Each of these six steps can be used as a tool for improving decision-making which help the manger to overcome the barriers experienced in using this decision technique.   The six steps include defining or framing the question, searching for relevant evidence or source of information, appraising the quality of the data, determining the relevance or applicability of the data, analyzing actionability, and evaluating the possible outcome of the decision (Health-evidence.ca, n.d.). Essentially, organizational support of the managers’ use of the tools assists in the decision-making process, making the manager less reliant on anecdotal evidence and consultants (Rundall et al., 2007).

The IDT suggests that managers believe that useful information in decision-making is characterized by the information’s accessibility, accuracy, applicability, and actionability (Rundall, et al., 2007). In this case step one is already define by the organization’s leadership to eliminate or introduce new programs. Therefore, the manager must determine what the best tools to accomplish this task are....
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