DECISION MAKING

DECENTRALIZATION
STRATEGIC PLANNING AND
OPERATIONAL PLANS
 CENTRAL OBJECTIVE

 At the end of the class students will be able to acquire adequate

knowledge regarding decision making, decentralization and
operational & strategic planning and will be able to apply this
knowledge in their educational and service area with a positive
attitude.
SPECIFIC OBJECTIVES

 define decision making

 state the principles of decision making
 explain the process of decision making.
 follow the techniques of decision making
 apply decision making models
 explain decentralization
 describe the strategic planning
 enumerate the operational planning
 DEFINITION

 Decision making is the selection of one alternative

from two or more possible alternatives
(Terry)
 DEFINITION

 Decision making is to solve any obstacle that stands between

decision maker and accomplishment of the organization
(Hodge and Johnson)
 BASIC ELEMENTS OF
DECISION MAKING

According to B. Governey the following are minimum 4 elements

that can be used to take a decision
 There must be a choice
 Choice must be conscious
 Choice must be oriented by various purposes
 Choice must lead to an action
 FEATURES OF DECISION
MAKING

 Selection of the most desirable alternative

 Rational selection
 Goal oriented
 May be positive or negative
 Reflects action commitment
FEATURES OF DECISION MAKING

 Time as an important dimension of decision making

 Group participation
 Must take account of personal and material resources
 To be communicated
 Efficiency in implementation
 Evaluation .
OBJECTIVES OF DECISION MAKING

 To reach optimum and most desirable result

 To perform other fundamental functions of
management example planning, organizing,
controlling.
 To resolve conflict
BASIS OF DECISION MAKING

Intuition Facts

experie Authority
nce
 DECISION LEVELS

Strategic
Tactical level Operational level
level
• highest level • support strategic • everyday decisions
• general direction decision • immediate and
• long time goal • medium-range with short term impact
• philosophies moderate
• values consequences
DECISION MAKING
PROCESS
 TYPES OF DECISIONS

Analytical decision

Judgmental decision TYPE Mechanistic decision

S

Adoptive decision
MECHANISTIC DECISION

 Routine and repetitive in nature

 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

 Helps to solve the complex problems

 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

 Involves a problem with a limited number of decision variables

but the out of the decision alternatives are unknown
 Useful in marketing investment
 Solve the personal problems.
 ADAPTIVE DECISION

 Involving a problem with a large number of decision

variables where outcomes are not predictable.
 Suchill structured problems require contribution of
many people with diverse technical background.
 Eg. Research finding.
 DECISION STRATEGIES

Optimizing
 analyze a problem
 determines desired out comes
 identifies possible solutions
 predict the consequences of each actions
 select the courses that yields the greatest amount of preferred
outcomes.
 DECISION STRATEGIES

 Satisfying: It is an approach, where by an individual chooses a

problem solutions, and then select best of remaining options.
 Mixed scanning: making a decision that satisfies to remove least
promising solutions, and then select best of remaining options.
 Opportunistic: making a decision for the solution chosen by
problem identifier.
 DECISION STRATEGIES

 Do nothing: taking decision after waiting for the storm to pass.

 Eliminate
critical limiting factor: making a decision by removing
most powerful obstacle to success.
 Maxima: an optimistic approach in which, while assuming the
highest possible pay off from use of any action the individual
chooses that action alternative that will yield the largest pay off.
 DECISION STRATEGIES

 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.
 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.
 DECISION STRATEGIES

 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.
 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.
FACTORS AFFECTING
DECISION
MAKING
 DECISION MAKING AUTHORITIES

Individuals as decision makers

 Autocratic manager‘s - more costly, less effective and represents a threat to
his/ her position. 3 behavioral characteristics that influence the decision
making.
 Perception of the problem
 Personal value system
 The role theory: it predicts how actions will be performed in certain roles
and how it will be affected certain circumstances.
 DECISION MAKING AUTHORITIES

Group factors in decision making

 Group comprises two or more people who share common interest and
come together to accomplish an activity through face to face interaction.
 Commitment to the decision and to the implementation is important and
may be increased by participation in the decision making process.
 Advantages of group participation include Increasing self-expression,
innovation and development and Increases the commitment
 DECISION MAKING AUTHORITIES

Committee Aspects in Decision Making

A committee a group of people chosen to deal with a particular
topic or problem.
 It can be formal or informal committee.
A committee appointed to collect data analyze finding make
recommendations is an ad hoc committee‘.
 TOOLS OF DECISION MAKING

Operational
Judgmental
Delphi technique research Decision tree
technique
technique
 Judgmental technique

 Oldest technique
 Subjective in decision making
 Based on past experience and intuition about future
 Useful in making routine decision
 Cheap and not time consuming
 May be Hazardous due to a chance for taking wrong decision and rarely
used in large capital commitments.
 Operational Research Technique (OR)

 Analysisof decision problem using scientific method to

provide manager the needed quantitative information in
making decision
 Operational research makes the decision analytic, objective
and quantitative based.
 Steps of OR technique

 Construction of mathematical model that pinpoints the important factor

in the situation.
 Definition of criteria to be used for comparing the relative merits of
various possible courses of action.
 Procuring empirical estimates of the numerical parameters in the model
that specify that particular situation to which it is applied.
 Carrying out through the mathematical process of finding and series of
action which will give optimal solution.
 Types of Operational Research Technique

 Linear programming: Uses linear mathematical equations to determine the

best way to use limited resources to achieve maximum results.
 This technique is based on the assumption that a linear relationship exists
between the variables and the limits of variation can be calculated.
 Linear programming is a sophisticated short cut technique in which
computers can be used. Three conditions must be existing before linear
programming must be utilized.
• Either a maximal or a minimal value is sought to optimize the objective. The
value may be expressed in terms of cost or quantity.
 Linear programming

• The variables affecting the goal must have a linear relationship. The ratio
of change in one variable to the changes in the other variable must be
constant.
• Constraints to the relationship of the variable exist.
 It can be used to determine a minimal cost nutrition diet or determine a
class size, class hours, and instructors in school of nursing.
 Queuing theory

 Deals with waiting lines or intermittent servicing problems

 Itbalances the cost of waiting versus the prevention of waiting by increasing
the services
 A group of items waiting to receive service is known as a queue
 By decreasing or eliminating the waiting line to reduce waiting line cost,
there is an increase in cost of labor and physical facilities.
 Games theory

 In normal games, each player or group of player tries to

choose a course of action which will frustrate opponent‘s
action and help in winning the game
 The same will apply in the context of business by maximize his
loss.
 Programme evaluation and review
technique (PERT):

Network system model for planning and control under certain

conditions
It Involves
 Identifying the key activates in a project
 Sequencing the activities in a flow diagram
 Assessing the duration for each phase of work.
 Computers in decision making

In management information system computers can be used for various activities

like
 patient classification system
 supplies and material management system
 staff scheduling
 policy and procedure changes and announcements
 budget information and management
 statistical reports and administrative reports
 memos etc.
 Delphi technique

 Itallows members who are dispersed over a geographic area to

participate in decision making without meeting face to face
 This is possible through the use of questionnaire
 The members will return the questionnaires anonymously; the
results of the first questionnaire are centrally compiled and sent
to each member
 Again the members are asked for suggestions
 Delphi techniques

 This process continues until the consensus is reached

 Little changes usually occur after the second round.
 The Delphi technique is free from others influence.
 Doesn‘t require physical presence.
 Appropriate for scattered group.
 But it is time consuming.
 Decision trees

A decision tree is a graphic method that can help the supervisor in visualizing the
 alternatives available
 Outcomes
 risks
 information needs for a specific problem over a period of time.

Helps to see the possible directions and to evaluate the consequences .

Begins with a primary decision having at least two alternatives.
Predicted outcomes considered and the need for further decision is contemplated.
MODELS OF DECISION
MAKING
 THE NORMATIVE MODEL

It is assumed to maximize satisfaction and fulfils the perfect knowledge assumption.

Define and analyze the problem.

Identify all available alternatives.

Evaluate the pros and cons of each alternative.

 Rank the alternatives.

Select the alternative that maximizes satisfaction.

Implement

Follow up.
 The Decision Tree

 Allfactors considered important to a decision can be represented on a

decision tree
 focus on protecting the quality and acceptance of the decision and deal
with adequacy of information, goal congruence, structure of the problem,
acceptance by subordinates, conflict, fairness, and priority for
implementation.
 Probabilitiesof both positive and negative consequences of each action
and event are estimated and recorded on the appropriate branch.
The Decision Tree
 The Descriptive Model

Based on the assumption that the decision maker is a rational person

looking for acceptable solutions based on known information.
This model allows for the fact that many decisions are made with
incomplete information because of
 Time
 Money
 people limitations.
 Steps In The Descriptive Model

 Establish acceptable goal.

 Define subjective perceptions of the problem.
 Identify acceptable alternatives.
 Evaluate each alternative.
 Select alternative.
 Implement decision.
 Follow up
 The Strategic Model

 Strategic decision making usually relates to long-range planning

 Optimizing Model

 Decision maker select the solution that maximally meet the objective for
a decision.
 Usually this process involves assessing the pros and cons of each known
outcomes as well as listing benefits and costs associated with each
option.
 The goal is to select the most ideal solution.
 Thisprocess is most expedient and may be the most appropriate when
time is an issue.
 ADVANTAGES OF DECISION MAKING

 Order and direction that enables managers to determine where

they are.
 Provide a frame work data gathering which is relevant to the
decision.
 Allows application of previous knowledge and experience that
minimize errors and improve quality of patient care and work of
an organization.
 Increase manager‘s confidence and ability in making decision.
DECENTRALIZATION
 DECENTRALIZATION

 Division of activities by forming departments

 Aims on attaining a better quality of patient care through benefits derived from
specialist nurses.
 Departmentalizationaims to provide better arrangements, control of facilities,
equipments and materials required to perform the necessary service.
 The nursing service administrator should explicitly define the standards,
policies, and scope of decision to be undertaken by top administration and
those to be handled by departments and their subunits.
Decentralization versus Centralization
 Definition of decentralization

 Decentralization is the dispersion or delegation of

responsibilities and the authority to lower levels
of an organization.
 ELEMENTS OF EFFECTIVE
DECENTRALIZATION

 Freedom to function effectively

 Support from Peers and leaders
 Concise and clear expectations of the work environment
 Appropriate resources
 Advantages

 Relieves top manager from burden of managing.

 Encourages subordinates to undertake responsibility.
 More freedom to managers.
 Increases motivation of subordinates.
 Enhances competition among various departments/units.
 Helps setting up of profit centers.
 Promotes development of general managers.
 Limitations

 Maintenance of uniform policy throughout organization becomes difficult.

 Increases complexity of coordination.
 May lead to loss of control by superior level managers.
 May be limited by inadequate control techniques.
 May be constrained by inadequate planning.
 Limited by inadequate training.
 STRATEGIC AND
OPERATIONAL PLANNING
 STRATEGIC AND OPERATIONAL
PLANNING

 Planning is a deliberative, systematic phase of the nursing

process that involves decision making and problem solving.
 In planning the nurse refers to the client‘s assessment data and
diagnostic statements for direction and formulating client goals
and designing the nursing strategies required to prevent,
reduce or eliminate the client‘s health problems.
 Strategic planning

 organization's process of defining its strategy, or

direction, and making decisions on allocating its
resources to pursue this strategy.
 Long term plan
 Purposes of strategic planning

 To utilize available resources

 To manage the performance of the department
 To acquire and develop new practices
 To improve the goals values and communication
 To bring changes in operations, management and organization
Strategic planning process
 OPERATIONAL PLANNING

 Operational plans are single use, short term plans derived from
the strategic plan to accomplish the goals and objectives of the
organization.
 Itlinks the strategic plan by delivering organizational activities
and the resources required to provide them.
 These plans usually establish the activities and budgets for
each part of the organization
 Concept and meaning

 An operating plan includes the actions to achieve the set objectives

 The plan is a step by step process of achieving goals and objectives.
 Goals of strategic and operational plans are the same, but they differ in
their objectives
 These are management plans and written blue prints to achieve goals and
objectives
Steps in operational planning
Operational plan V/S Strategic plan
Operational plan V/S Strategic plan
Operational plan V/S Strategic plan
SUMMARY
CONCLUSION
 JOURNAL ABSTRACT

 Decision-Making in Nursing Practice: An Integrative Literature Review, journel of clinical nurses

 C.W. Nibbelink, B.B. Brewer
 Aims and objectives: Identify and summarize factors and processes related to registered nurse’s patient
care decision making in medical-surgical environments. A secondary goal of this literature review was to
determine whether medical-surgical decision-making literature included factors that appeared to be
similar to concepts and factors in Naturalistic Decision Making. Background: Decision-making in acute
care nursing requires an evaluation of many complex factors. While decision-making research in acute
care nursing is prevalent, errors in decision-making continue leading to poor patient outcomes.
Naturalistic Decision making may provide a framework for further exploring decision-making in acute
care nursing practice. A better understanding of the literature is needed to guide future research to more
effectively support acute care nurse decision-making.
 JOURNAL ABSTRACT

 Design: Pubmed and CINAHL databases were searched and research meeting criteria
was included. Data were identified from all included articles and themes were
developed based on these data. Results: Key findings in this review include nursing
experience and associated factors; organization and unit culture influences on
decision-making; education; understanding patient status; situation awareness; and
autonomy. Conclusions: Acute care nurses employ a variety of decision-making
factors and processes. Informally identify experienced nurses to be important
resources for decision-making. Incorporation of evidence into acute care nursing
practice continues to be a struggle for acute care nurses. This review indicates that
Naturalistic Decision Making may be applicable to decision-making nursing research.
 ASSIGNMENT

 Develop an operational plan to prevent hospital acquired

infections
 REFERENCE

 Vati J. principles & practice of nursing management and administration. 1st edition.
Jaypee brothers medical publishers. New Delhi;2013. P.no 192-200
 K.Deepak, Chandran S, Kumar M. A comprehensive text book on nursing management.
2nd edition. Emmess medical publishers. Banglore;2019. P.no 46-55, 434-440, 74-80
 Basavanthappa BT. Nursing administration. Jaypee brothers medical publishers . New
Delhi; 2009.
 Venketaramen A. Newer Trends in Management of Nursing Services and Education. First
edition. Jaypee Brothers Medical Publishers. New Delhi ; 2017