Decision Making Models

COMPREHEND DECISION MAKING and PROBLEM SOLVING

I. Define decision making

Decision making

A complex, cognitive process often defined as choosing a particular course of action. This implies that there was doubt about several courses of action and that a choice was made to eliminate the uncertainty.

( Lancaster) A systematic, sequential process of choosing among alternatives and putting the choice into action.

Decision making is a process that involves steps or actions that one might take in solving problems relevant to the discipline of nursing. The relationship of critical thinking and critical analysis in relation to the decision making process: Critical thinking is a skill developed in looking for alternative solutions to problems and adopting a questioning approach. Critical analysis is a tool used in critical thinking and may involve asking the following questions:

* What is the central issue?

* What are the underlying assumptions?

* Is there valid evidence?

* Are the conclusions acceptable?

Decision making is important to the discipline of nursing for dealing with problems arising in the management of nursing resources and clinical practices. Nurse administrators must determine the best course of action for managing staff members, budgets, supplies, and in governance decisions concerning the nursing department within the large organization.decision must be made concerning the nursing actions that may be required by a group of patients with similar medical and nursing diagnoses and demographic and psychosocial characteristics. Nurses also assist patients in making decisions concerning health care. Nurses in both of these roles can make a significant impact on the delivery of health care by learning to make the best decisions.

II. Distinguish different models of decision making

Multiattributed Utility Model (MAU Model)

* involves multiple goals or criteria.

* Attribute a characteristic of an alternative or potential solution for a problem. The utility for an alternative or problem solution involves assigning criteria that demonstrate usefulness. Utilities may include worth, payoff, psychological value, or level of satisfaction. The overall utility might be defined as the extent to which an alternative or problem solution satisfies a criterion or goal defined for the decision-making session, usingone or more utility criteria assigned a number value.

* Utilities derived from the individual criteria of a decision situation may be weighted and aggregated to determine a problem solution or alternative with the highest overall multiattribute score.

* This model is most clearly understood by applying 4 steps:

 Attribute

suppose you want to select a nurse manager from 3 potential candidate.First, identify the attributes for the nurse manager. Suppose the 3 most important attributes for this decision situation are education, previous experience, leadership style.

 Utility

III. Steps in the decision making process

Routine Process

5 steps that are applicable to individual or group decision making.

Step 1

Involves the identification of the problem that needs a solution by answering several questions:

* What is the story or issue?

* How long has the problem existed?

* What is the history of the problem?

* What is wrong?

* What improvement is needed?

The identification phrase should include an analysis of the situation in which the problem occurs by gathering all of the pertinement facts. Facts may be determine by answering several questions:

* What is the desirable situation?

* What are the presenting symptoms of the problem?

* What are the discrepancies?

* What are the related issue?

* Who is involved?

* When?

* Where?

* How?

The identification phrase involves establishing goals for the decision by asking:

* Why is a decision necessary?

* What specific aspects of the decision need to be determined?

* What is the purpose of the decision?

The goal of the decision may be further defined by setting and weighting criteria. Criteria are comprised of certain standards that should be met when the decision is made. Typical criteria for alternative