Decision making is the function of a manager at any level. Employees of organizations, as well as specialists of consulting companies, usually take part in its preparation. Managers implement their managerial activities through decisions; therefore, they are leaders’ primary “creations”. The product of the direct actions of the leader is the adoption of competent decisions, whereas the creation of specific products is carried out by various performers at particular workplaces. Battal, Durmuş, and Çinar (2017) argue that “leadership behavior in organizations is crucial in achieving its goal of organizing and acting in this direction” (p. 10). The purpose of this paper is to discuss the main decision-making features, methods, and their impact on the results of the activities of leaders and medical institutions.
Decision making is a task for a manager, which is solved during the management process. The decision-making process consists of a sequence of steps and procedures and is aimed at resolving a problem situation. The actions and procedures have direct and reverse relationships. The reverse ones reflect the iterative, cyclical nature of the relationship between steps and procedures. Iterations in the decision-making process are due to the need to clarify and adjust the data after performing specific procedures and returning to work at any previous stage.
The process of preparation and decision-making involves various types of employees. These are managers, doctors or nurses, and other experts, who solve specific issues on particular problems. Undoubtedly, in making decisions, leaders play a significant role. They make decisions based on their preferences and skills and are responsible for them. Decision making, as well as the exchange of information, is a vast part of any leadership function. The need for decision-making exists at all steps of the management process, is associated with all sectors of management activity. Therefore, it is vital to know the meaning and essence of decisions. It is especially important in the healthcare area since the decisions can be critical for human life.
To begin with, it is worth defining the very concept of a decision, key for this paper. Usually, in any process, a person or group have to choose one of some possible actions. As a result, they will come to a specific decision. Every person has to choose something daily dozens of times, developing first-hand abilities and acquiring decision-making skills. There are multiple examples: the selection of dishes from the proposed menu, of the most convenient transport route, or a specialty in obtaining a vocational education. A decision precedes any act of an individual or collective action. Decisions are a common behavior form, both of a person and social groups. This universality is due to the conscious and focused nature of the human activity. Nevertheless, despite the universality of decisions, their making in the process of managing an organization is significantly different from private decisions.
First, the management entity makes a decision based not on its needs, but in relation with some issues of a particular medical institution. Leaders must be aware of the consequences of their actions. A private choice of individuals affects their lives and some of their friends or relatives. Healthcare managers, especially of high rank, choose the direction of actions not only for themselves but also for a hospital as and its workers and patients. Their decisions can significantly affect the lives of many people (Faddis, 2019). If the medical institution is big and have some influence, its leaders’ decisions can affect entire states. For instance, a decision to close an unprofitable hospital may significantly increase number of sick people and also unemployment.
In private life, people making a decision, as a rule, fulfill it themselves. In the organization, there is a particular division of labor. Some employees (managers) are engaged in solving emerging problems and making decisions, while others (performers) are involved in the implementation of decisions already made. In addition, in private life, people make decisions independently by their intelligence and experience. In managing an organization, decision making is a much more complex, responsible, and formalized process that requires training. Not every employee of a medical institution, but only with specific professional knowledge and skills is empowered to make decisions independently. Management decisions can be intentional, based on a competent analysis of various sides of a situation, and unintentional, which contains the probability of errors and uncertainty. In the healthcare area unintentional decisions can be met often because this work requires work with people and thus involves many emotions. However, decisions made should be based on reliable, current, and predicted information, and analysis of all factors that influence decisions, taking into account the anticipation of its possible consequences.
To be effective and to achieve some goals, the decision must satisfy several requirements. First, this is the unity of goals: the consistency of decisions to previously set goals. To do this, the problem should be structured; the goals must be reasonable and competent. The decision validity is essential, as well as the conformity of the rights and obligations of decision-making parties. Whenever possible, the arguments should be formalized (contain statistical, economic, medical, and other data). To achieve validity and competence, it is necessary to ensure that scientific approaches to the development of the decision are applied, and the effect of various factors on its effectiveness is studied.
In addition, clarity and conciseness of the wording (focus on a specific performer), as well as the timeliness and speed of decision-making, which increase the value of the decision, are critical. Any decision made by leaders must be objective: managers should not ignore real conditions or the actual state of affairs when developing decisions. For this, it is necessary to obtain high-quality information characterizing the solution development system and ensure the comparability of options. It is also crucial to ensure the multivariance of decisions and achieve their legal validity.
Leaders should be able to verify and control the implementation of decisions made. The lack of real control measures can make the rest of the preparation and decision-making work pointless. Automation of the process of collecting and processing information and the process of developing and implementing decisions are useful. The use of computer technology significantly reduces the time to create a decision and increases its validity. Undoubtedly, responsibility and motivation are also necessary when making a quality and practical decision. In addition, to be of high quality, the decision must be stable in effectiveness against possible errors in determining the initial data. Otherwise, insignificant deviations of the initial data, which can occur at any moment and for various reasons, will make the result ineffective.
The goal of any management decision is the ideal result of future activities. In other words, these are the specific results that have to be obtained after the implementation of the decision in certain conditions and for a fixed time. Moreover, the goal reflects the reaction of the environment to the system. In other words, its implementation should be beneficial for someone’s health or for the common state of a medical institution and, therefore, a city or a region.
The goal should be unambiguously formulated, understandable to the performers, and measurable (doctors’ or patients’ feedback can be used for this). It should also be real, achievable on time, and compatible with the goals of individual groups of performers. Moreover, sometimes the goal should be connected with the remuneration system to motivate the actions of the performer in the direction necessary for its achievement. It is also worth noting the need to formalize goals. Thanks to the combination of these qualities of any managerial goal, the leader will be able to achieve better results with the least difficulty.
Management decision as a process consists of stages: preparation, adoption, and implementation of the decision. During preparation, an analysis of the situation, search, collection, and processing of information is carried out. Problems that need to be addressed are also identified and formed. At the adoption stage, the development and evaluation of alternative decisions are carried out. At the stage of implementation, measures are taken to concretize the decision and bring it to the performers (Bates, 2006). Here, control over the progress of its application is carried out, necessary adjustments are made, and the result obtained is evaluated.
Making a managerial decision is the most critical stage of administrative activity in any medical institution. Any decision is always connected with the person, the leader. Therefore, from a psychological point of view, decision making is always a critical moment of a behavioral act connected with a choice, a preference for one option over others. Decisions are always social, and they can have an enormous effect on someone’s life. Therefore, any decision should be projected on the person, team, organization, which take one or another part in its development and implementation.
References
- Bates, S. (2006). How leaders communicate big ideas to drive business results. Employment Relations, 33(3), 13-19.
- Battal, F., Durmuş, İ., & Çinar, E. (2017). The effects of organizational citizenship behaviors and decision-making styles on transformational leadership behavior. Electronic Turkish Studies, 12(31), 1-28.
- Faddis, T. (2019). The ethical line:10 leadership strategies for effective decision making. SAGE Publications.