Decision-Making-Problem-Solving-Notes.pdf

DECISION MAKING & PROBLEM SOLVINGFRITZ A. BUCAO, RMT A GOOD DECISION Should be based on a complete investigation of the root causes and potential problems, as well as obvious symptoms. Should identify and evaluate alternative solutions. Should involve the selection of the best sol...

DECISION MAKING & PROBLEM SOLVINGFRITZ A. BUCAO, RMT A GOOD DECISION Should be based on a complete investigation of the root causes and potential problems, as well as obvious symptoms. Should identify and evaluate alternative solutions. Should involve the selection of the best solution by in-depth analysis of the available information. Should encompass an effective strategy for implementing the solution. HUMAN ELEMENT Emotions, prejudices, peer pressure and personal interest exert tremendous influence on the choices made. Never completely eliminated; must be controlled. DISCLOSURE Effective control method and balancing action, providing the participants have the power and independence to consider its impact and to act accordingly. ASSET By using objective analytical tools to evaluate the situation and allowing the human touch to provide the perspective and context for selection and implementation. STEPS IN MAKING A SOUND DECISION 1. Recognition 2. Investigation 3. Definition 4. Identification of Alternatives 5. Evaluation 6. Selection 7. Implementation 8. Follow-up To become aware that something is wrong and needs the attention of the manager. as a complaint from a physician or employee RECOGNITION as a flag in the quality control data Recognizing a problem Not as simple as it may appear May only be a random occurrence Includes collecting data, interviewing staff, and gathering information During this fact-gathering stage: INVESTIGATION Manager should be alert to ancillary issues that may have contributed to the problem but were not at first readily apparent. Defining the problem Determining all the issues and aspects of the question, including people, equipment, communication, supplies, and the workflow itself. Deviation DEFINITION A one time, random human error Effectural problem The symptom or surface sign that may hide the real cause of a problem.  Causal problem The root cause of the problem. Determining what solutions are available to remedy the situation. Key at this stage: To be aware of as many alternative solutions as possible; the manager then has a range IDENTIFICATION OF ALTERNATIVES of options to choose. Although some proposals can be rejected outright, considering each alternative as it becomes known is time-consuming, and the manager may settle on a poor choice simply because of time constraints. After the pool of feasible solutions has been compiled, a thorough evaluation should be conducted (step 5), and the best alternative SOLUTION EVALUATION AND SELECTION selected (step 6). Variety of tools can be used to select the most suitable alternative. Developing a plan to implement the final decision and devising a mechanism to monitor compliance – part of the IMPLEMENTATION AND FOLLOW-UP management functions and illustrates the central role of decision making in the overall operations of the laboratory. DECISION MAKING TECHNIQUES QUALITATIVE TOOLS QUANTITATIVE TOOLS Involve personal judgment, solicitation of Include both QC measures and financial  advice and systematic option review. data. QUALITATIVE TOOLS PERSONAL JUDGMENT Begin at birth to develop skills in choosing between options. These grow with maturity and experience. Specific duties and demands of the workplace and profession become familiar through FORMAL TRAINING and CAREER ADVANCEMENTS. Personal knowledge – vital resource in evaluating alternatives and making decisions. SOLICITATION OF ADVICE Asking for opinions, organizing a committee, seeking a consensus from colleagues and coworkers, and delegating the task to staff members. Forming a group or committee to focus on a problem is one of the most common approaches to decision making: 1. Brainstorming -technique used in groups whereby everyone freely and spontaneously throws out ideas and solutions for later evaluation without regard for validity. 2. Synectics - group whose members are brought together as a problem-solving team 3. Nominal grouping - a highly structured meeting in which individuals write their original ideas in private, with the alternative solutions anonymously presented to the group for discussion and then voted on and tallied in secret. 4. Delphi method - modification of nominal grouping -input and opinions of experts are solicited on questionnaires before the meeting. - results are then discussed and voted on anonymously. SYSTEMATIC OPTION REVIEW -Involves prioritizing each option according to its apparent attractiveness. T CHART One popular format for evaluating facts and information Clarifies the opportunities and risks associated with each option and makes the selection process more objective. QUANTITATIVE TOOLS Operations Research (OR) one branch of management science that specializes in providing quantitative tools for decision making. Four main areas: 1. Probability analysis - Measures risk by assigning a value, expressed as a percentage, to the likelihood of a specific event occurring. 2. Queuing theory -Provides recommendations for the number of staff (phlebotomists, clerks, technical personnel, and so on) needed to handle an unpredictable workload. 3. Linear programming -A tool for allocating limited resources among competing needs. 4. Simulation -Designs models to imitate real-life conditions so the different intervention scenarios can be compared. Probability Analysis A PRIORI PROBABILITY obtained by deductions based on assumed conditions. Lab establishes normal ranges but cannot predict with certainty where patient’s result will fall. EMPIRICAL PROBABILITY determined by recording actual events over a specific period of time and calculating the number of times each event occurs. Used when the lab establishes QC ranges for a new lot of reagents or controls. SUBJECTIVE PROBABILITY Based on the knowledge and experience of the individual or group, a prediction is made of the likelihood of an event occurring. Queuing Theory Was originally designed to determine the number of airline reservation clerks needed for a given time period Is designed to determine the staffing requirements of a workstation with the following operational needs: 1.Need for prompt service 2.Need for an adequate number of servers to meet an urgent demand Once these parameters have been determined, they can be entered into a queuing program for staffing level calculations. Linear Programming Was designed to resolve the ff. problems: Limits and restraints on the availability of resources (staff, time, expenses) Constant need for decisions as to allocation of these limited resources among competing needs Pressure to maximize income and minimize losses Process of elimination and selection illustrates the procedure. Here are some questions and variables associated with this type of decision: Does the instrument perform all the tests required, or is additional equipment necessary? Are the throughout and turnaround time acceptable? Is the price within the laboratory budget? Simulation The computer has made possible the development of models that closely duplicate the conditions found in real-life settings. Attempt to identify important variables, which the manager can then manipulate to test the impact of different options on the system. EXAMPLE: Computer projection of the impact on length of patient stay in the hospital if CK isoenzymes are batched and run at different times (e.g. every 2, 4, or 8 hours)instead of on a STAT basis.