Decision Making in a Healthcare Organization
MHA 601: Principles of Healthcare Administration
Professor Jack Lazzare
December 19, 2011
DECISION MAKING IN HEALTHCARE ORGANIZATION 2
In the health care profession a CEO will be asked to make a lot of difficult decisions. The CEO will not only have to make decisions that fit the ongoing vision of the healthcare facility he/she may work at they will also have to form stable relationships with their peers, media, and staff. Decision making occurs in all organizations. The decision-making process begins with identifying a question, problem, or area needing improvement, or an operational issue. Problems, issues, questions, and operational challenges come to leaders and managers from many different people both within and outside the health organization (Pablo, 1996). To make the important decision that was given to us in the case study, I would use the garbage can model and its subsets to help me come to a conclusion. This decision involves a lot of people so the choice that will be made will affect all parties involved. In this paper I will discuss how I would tackle this problem with the various tools of decision making through the readings that we have had.
The Garbage Can Model
How can the garbage can model help in this situation? The garbage can model was invented to expand the understanding of the organization. It addresses the problem that is going on at that time and accepts confusion as a reality. In the garbage can model loose coupling is required in an organization to understand decision making. The garbage can model has also been introduced as a possible method to understand how an organization learns (Tsang, 1997). In the case study the CEO is faced with a myriad of issues like for instance trying to keep the physicians, and adequate staff at the hospital not only that if they were to leave they have threatened to go to their rivals hospitals across the city. The CEO also has to deal with a possible
DECISION MAKING IN HEALTHCARE ORGANIZATION 3
lawsuit because the nurse who possibly has HIV has been asked to leave the operating room to work somewhere else. Would this not spark a fire? Could asking the nurse to leave no matter how they tried to butter the deal up still seem like covert discrimination? So the hospital is about to be hit by a media freight train if they cannot get this under control. The garbage can model allows for the CEO to handle these problems accordingly. “Garbage can decisions can occur in any organization but are more likely to be found in ‘organized anarchies’ where decisions are made under ambiguity and fluid involvement of participants.” Garbage can models are attempts at finding logic and order in the mist of decision-making chaos. Garbage, defined as sets of problems, solutions, energy, and participants, is dumped into a can as they are produced (streams of “garbage” in time) and when the can is full, a decision is made and removed from the scenario (Takahashi, 2002). The garbage can model depicts the chaotic nature of decision making.
Temporal order is a component of the garbage can model. Temporal order replaces sequential order. Time is spatial in that a multitude of issues, problems, information flows, and sensing mechanisms can bombard decision makers in short or long time blocks. How problems and information to resolve the problems arrives in time has relatively equal priority as the evaluation of their importance. Arrival time and sequence in the current context influences decision makers’ attention to the situation. “The process is thoroughly and generally sensitive to load. An increase in the number of problems, relative to the...