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DECISION MAKING

DEFINITION
Decision making is a systematic process of choosing among alternatives and putting the choice
in to action. -Lancaster and Lancaster
Decision making process is a conscious, intellectual activity involving judgment, evaluation and
selection from among several alternatives. -According to ClaudeDefinition
OBJECTIVES OF DECISION MAKING

 To reach optimum and most desirable result.

 To perform fundamental functions of management.
 To resolve the conflicts.
TYPES OF DECISION MAKING
There are 4 managerial decisions
a. Mechanistic decision b. Analytical decision
c. Judgmental decision d. Adoptive decision
Mechanistic decision
 Routine and repetitive in nature
 It usually occurs in a situation involving a limited number of decision variables where the
outcome of each alternative is known.
 Tools used for these kinds of decisions are charts, list, decision tree etc.

Analytical decision

 This decision helps to solve the complex problems.

 It involves a problem with a large number of decision variables where the outcome of each
decision alternatives can be computed.
 Computational techniques involve linear programming and statistical analysis.

Judgmental decision
 Decision involves a problem with a limited number of decision variables but the out of
the decision alternatives are unknown.
 These types of decision are useful in marketing investment and to solve the personal
problems.

Adaptive decision
 Decisions involving a problem with a large number of decision variables where
outcomes are not predictable.
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 Such ill structured problems require contribution of of many people with diverse
technical background. Eg. Research finding.

PRINCIPLES OF DECISION MAKING :

1. Principles of autonomy : This principle is form of personal liberty also referred to as freedom
of choice or accepting the responsibility for one‘s choice.
2. Principle of beneficence : The principle status that the actions one takes should be done in an
effort to promote good.
3. Principle of paternalism : This principle is related to positive beneficence in that one
individual assumes the authority to make a decision for another individual.
4. Principle of utility : This principle reflects a belief in utilitarianism on the belief that what is
best for the common good outweighs what is best for individuals.
5. Principle of justice : This principle states that equals should be treated and unequal should be
treated according to their differences.

DECISION MAKING STAGES

Developed by B. Aubrey Fisher, there are four stages that should be involved in all group
decision making. These stages, or sometimes called phases, are important for the decision
making process to begin
1. Orientation stage – This phase is where members meet for the first time and start to get
to know each other.
2. Conflict stage – Once group members become familiar with each other, disputes, little
fights and arguments occur. Group members eventually work it out.
3. Emergence stage – The group begins to clear up vague opinions by talking about them.
4. Reinforcement stage – Members finally make a decision, while justifying themselves
that it was the right decision.
It is said that critical norms in a group improves the quality of decisions, while the
majority of opinions (called consensus norms) do not. This is due to collaboration
between one another, and when group members get used to, and familiar with, each other,
they will tend to argue and create more of a dispute to agree upon one decision. This does
not mean that all group members fully agree — they may not want argue further just to
be liked by other group members or to "fit in"
TECHNIQUES OF DECISION MAKING
In order to evaluate the alternatives, certain quantitative techniques have been developed which
facilitate in making objective decisions. Some of the techniques are:
at an overall minimum cost.

1. Operational research
2. Decision tree
3. Linear programming
4. Gaming or game theory
5. Network analysis
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1Operational research : Is the scientific method to analysis of problems or it is the application

of specific method, tools and techniques to operations of system with optimum solution to the
problem.

2. Decision tree: Decision trees are model for solving a problem where decision of step on
model involve a series, the subsequent step depending on the outcome of previous step.So it is
graphical method for identify alternative actions, estimating probability and calculation of
expected results from an action.

3. Linear programming: Linear programming is a mathematical technique used for the purpose
of allocation of limited resources in a optimum manner. Linear means that relationships that are
handled are represented by straight lines and the word programming means making decision
systematically.

4. Gaming or game theory: It involves the simulation of a situation in order to gain the reality
of the situation . The game theory provides general rules concerning the logic that includes
strategic behaviour in competitive situations.

5. Network analysis : It is used for planning and controlling the project activities. Under this a
project is broken-down to small operations which are engaged in a logical cycle. A network
diagram may be drawn to present the relationship between all the operations involved.

NURSING ADMINISTRATION DECISION MAKING

According to Ann Bill Taylor

a. Non routine decision: made by directors of nursing. The out of the problem will be
unpredictable. Eg. Changing ways of organizing for the delivery of nursing care.
b. Routine decision: Routine decision: made by mid level and low level managers, the outcome
will be predictable. Eg. Assigning the duty roster, assign the security laws.
Generally decisions are broadly divided into two categories:
1. Typical, routine, unimportant decisions
2. Important, vital or strategic decisions
Routine decisions: Involve no extraordinary judgment, analysis and authority, since they are
dealing with less important problems. Routine decisions demand power to select the shortest
path, within the given means and ends.
Strategic decisions: Aim at determining or changing the means and ends of the enterprise. They
require a thorough study, analysis and reflective thinking on the part of administrators. Strategic
decisions are usually taken by top managers, while routine decisions are made mostly by lower
level managers.
DECISION STRATEGIES
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A strategy is an artful or cleaver plan for applying technique in pursuit of a goal. Before
selecting any method of decision manager should adopt a decision strategy. Some strategy suited
for some type of problems than others, they are;
1. Optimizing: It is an approach in which an individual analyze a problem, determines desired
out comes, identifies possible solutions, predict the consequences of each actions, and select the
courses that yields the greatest amount of preferred outcomes.
2. Satisfying: It is an approach, where by an individual chooses a problem solutions, and then
select best of remaining options.
3. Mixed scanning: making a decision that satisfies to remove least promising solutions, and
then select best of remaining options.
4. Opportunistic: making a decision for the solution chosen by problem identifier.
5. Do nothing: taking decision after waiting for the storm to pass.
6. Eliminate critical limiting factor: making a decision by removing most powerful obstacle to
success.
7. Maxima: an optimistic approach in which, while assuming the highest possible p ay off from
use of any action the individual chooses that action alternative that will yield the largest pay off.
8. Mini-regret: an approach designed to minimize the surprise resulting from any action
decision by selecting the action alternative that will yield a result midway between the most
desired and the least desired out comes.
9. Precautionary: making a decision by choosing the action that will maximize gain of
minimize loss regardless of opponents actions. It is useful when the manager engaged in a zero
sum conflict with another.
10. Evolutionary: while taking a decision individual has to make series of small changes
leading towards goal. It is based on the assumption that subordinates can better adjust to series of
small changes than a quantum leap.
11. Chameleon: taking a decision by making vague plan, adjusted to changing circumstances. It
consists of farming management decision in general terms, so that they can be interpreted,
differently at different times.
TIME AND BASIS FOR DECISION MAKING
There are six important bases for decision making which are referred to as aids to decision
making and they include experience, authority, facts, intuition, research, analysis and
experimentation.
1. Experience: Experience is the most important and valued basis for making decisions.
Experience gives the administrator the requisite vision, that trains him to apply his
knowledge to the best of its use and that helps him to recognize the crucial factors from
unnecessary details.
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2. Authority: Provides an important basis for enabling managers to take quick and sound
decisions.
3. Facts: Provide the solid basis for decision making. Decisions become wrong only when
adequate facts are not available on the problem. The computer technology has been
introduced for supplying greater facts to operating managers.
4. Intuition: It is the residuary basis for covering up deficiencies in other three bases of
decision making. It includes guess work, and common sense views.
5. Research and analysis: These are the most effective basis for choosing among
alternatives. It helps in finding out relationships among the other important variables.
6. Experimentation: This provides another means by which various alternatives can be
evaluated. Since experimentation becomes and expensive basis for decision making in
many cases, it is used sparingly for indicating the best course of actions in problems like
policy formation, product development, introduction of new organizational technique etc.

FACTOR AFFECTING DECISION MAKING

Internal factors

 Decision makers physical and emotional status

 Personal characteristics and values
 Past experience and interest
 Knowledge and Attitude
 Self awareness and courage
 Energy and creativity
 Resistance to change
 Sensitivity and flexibility
External factors
 Cultural environment
 Philosophical environment
 Social back ground
 Time
 Poor communication
 Cooperation
 Coordination

STEPS IN DECISION MAKING

1. Making the diagnosis

2. Analysing the problem
3. Searching alternative solutions
4. Selecting best possible solution
5. Putting the decision into effect
6. Following up the decision

1. Making the diagnosis

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The first step is to determine what the real problem is?. If the problem is not ascertained
correctly at the beginning, money and effort spent on the decision making will be a waste. The
original situation will not come under control. But new problems will start from this incorrect
appraisal of the situation.
2. Analyzing the problem
The problem should be thoroughly analysed to find out adequate background information and
data relating to the situation. This analysis may provide the manager with some revealing
circumstances that will help him to gain an insight into the problem. The whole approach should
be based around the important factors. Only pertinent and closely connected factors are selected,
as dictated by the principle of the limiting or strategic factor.
3. Searching alternative solution
After anodizing the problem attempts are made to find alternative solutions to the problem. In the
absence of alternatives decision making process will become.
4. Selecting best possible solution
Selection of one best course of action among the several alternatives developed; require an
ability to draw distinctions between tangible and intangible factors as well as facts and guesses.
The four criteria have been suggested by Dracker in selecting the best solution.
1. Proportion of risk to the expected gain.
2. Relevance between the economy of effort and the possibility of results.
3. The time considerations that meet the needs of the situation.
4. The limitation of recourses.
Instead of picking the best solution managers have to really on a course of action that is
satisfactory enough under the existing circumstances and limitations.

5. Putting the decision in to effort

The decisions can be made effective through the action of other people. In order to overcome the
opposing on the part of employee‘s managers can make three important preparations.
a. Communication of decisions
b. Securing employee acceptance
c. The timing of decisions

6.Follow up
the decision As a safe guard against the incorrect decisions managers are required to a system of
follow up care of the decisions so as to modify them at the earliest.
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DECENTRALIZATION

Definition of decentralization
Decentralization is the dispersion or delegation of responsibilities and the authority to lower
levels of an organization. Institution makes use of both centralization & decentralization. Top
management needs a positive attitude towards decentralization and they need competent personal
to whom they can delegate authority.
Definitions of Decentralisation
According to Henry Fayol, "Everything that goes to increase the importance of the
subordinate’s role is decentralisation, everything that goes to reduce it is centralisation."
According to James Stoner, "Decision making is the process of identifying and selecting a
course of action to solve a specific problem."
Decentralized structure
The decentralized structure is flat in nature and organizational power is spread out throughout the
structure. These are few layers in the reporting structure, and managers have a broad span of
control. Communication patterns are simplified and problems tend to be addressed with ease and
efficiency at the level at which they occur. Employees have autonomy and increased job
satisfaction within this type of structure.
Nursing Administration

Maternity Pediatric Surgery

Supervisor Supervisor Supervisor

Nurse Nurse Nurse Nurse

Nurse Nurse
De
Decentralization (Flat, Horizontal, Participatory) Structure
Flat organizational structures are characteristic of decentralized management. Decentralization
refers to the degree of which authority is shifted downward within an organization to its
divisions, services, and units. Decentralization is delegating decision making
In nursing, as in other organizations, delegation fosters participation, teamwork, and
accountability. A first line manger with delegated authority will contact another department to
solve a problem in providing a service. The first line manager does not need to go to his or her
department head of the other service, creating a communication bottleneck. The people closest to
the problem solve it, resulting in efficient and cost effective management.
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Research conducted on Magnet hospitals found the most of the hospitals has a decentralized
structure in which nurses had a feeling of control over their unit work environment. Porter
O‘Grady identified the following conditions as essential for effective decentralization:
 Freedom to function effectively
 Support from Peers and leaders
 Concise and clear expectations of the work environment
 Appropriate resources
ADVANTAGES AND LIMITATIONS OF DECENTRALIZATION
ADVANTAGES
The advantages of decentralization are as follows:
1. Relieves top manager from burden of managing.
2. Encourages subordinates to undertake responsibility.
3. More freedom to managers.
4. Increases motivation of subordinates.
5. Enhances competition among various departments/units.
6. Helps setting up of profit centres.
7. Promotes development of general managers.
8. Prepares mangers for rapid change in the organization.
LIMITATIONS
The limitations of decentralization are as follows:
1. Maintenance of uniform policy throughout organization becomes difficult.
2. Increases complexity of coordination.
3. May lead to loss of control by superior level managers.
4. May be limited by inadequate control techniques.
5. May be constrained by inadequate planning.
6. Limited by inadequate training.
7. Limited by inadequate number of qualified personnel at lower level.
8. It may be limited by external factors like; government regulations, taxation policy of
government, etc.

BIBLIOGRAPHY

Mr. .N Anoop .Mr. Kumar Chetan .M.R Mr. Deepak.K A “ A C oprehensive Text book on
Nursing Management” Edition 2013, Published by Manunath S Hedge. Page no 56-58

Vati Jogindra. “Principles and Practice OF Nursing Management and Administration “ Edition
2013, Published by Jaypee Brother, Page no 196-200