DECISION-MAKING 7/23/2018. Do not plant your dreams in the field of indecision, where nothing ever grows but the weeds of what-if.

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1 DECISION-MAKING Moving Beyond Eeny, Meeny, Miny, Mo Innovation and Excellence in Advanced Illness at End of Life 42 nd Annual Hospice & Palliative Care Conference September 2018 Charlotte, NC DECISION-MAKING Is decision-making an innate skill or one that is learned? It s BOTH! Some people can do it well almost without thinking, others have to practice to become good at it. DECISION-MAKING Do not plant your dreams in the field of indecision, where nothing ever grows but the weeds of what-if. " ~Dodinsky 1

2 DECISION-MAKING When making a decision, you can either spend your time, effort, and energy: Considering what would have happened if you had made a different decision. OR Making your decision work! *Indecision and what ifs can paralyze us and make us so slow to make decisions that we hinder progress.* DEFINITION OF DECISION-MAKING Decision making is identifying and choosing alternatives based on the one that: has the highest probability of success or effectiveness AND best fits your goals, desires, values. DEEPER DEFINITION Decision-making is the process of reducing uncertainty and doubt about alternatives to allow a reasonable choice to be made from among them. 2

3 REDUCING UNCERTAINTY Uncertainty is reduced, not eliminated. Because almost no decisions are made with absolute certainty, they have some degree of risk. A Chinese Proverb says: One cannot refuse to eat just because there is a chance of being choked. 3

4 DECISION MAKING STEP 1 Identify the Decision to be made What is the outcome you want to achieve? Put the goal in positive terms rather than negative I want to reduce inefficiency I don t want people to waste time STEP 1 IDENTIFY THE DECISION Would you tell me please, asked Alice, where I ought to go from here? That depends a good deal on where you want to get to, replied the Cat. I don t much care where, she replied. Then it doesn t matter which way you go. --Lewis Carroll, Alice in Wonderland STEP 1 IDENTIFY THE DECISION Imagine you need to purchase a car What might that decision statement look like? I want to buy a car OR I have to decide where to buy a car OR I need to decide what kind of car to buy B U T.... 4

5 STEP 1 IDENTIFY THE DECISION A better decision statement includes your desired outcome When buying a car, you may want good gas mileage or may need a car that holds a large family So a better decision statement might be I Want to Purchase a Car with Excellent Gas Mileage DECISION MAKING STEP 2 Gather Information details & data Available Resources Budget Timeframe Barriers Collect as much information as you can in the time you have STEP 2 GATHER INFORMATION Resources: Treasure hunt! Limitations/Weaknesses: Talk about regulations, budgets, policies, education Facts: Measurable, concrete Gut: How you feel, your instincts do not discount your intuition 5

6 DECISION MAKING STEP 3 Identify the Alternatives List all alternatives that may help you achieve your goal. Brainstorm possible courses of action. Be creative and open to possibilities. Do not limit yourself in this step! STEP 3 IDENTIFY ALTERNATIVES Helps to think in questions like: What if we. How can we. What would happen if. Have we thought about. Don t be afraid to challenge preconceived ideas DECISION MAKING STEP 4 Weigh the Evidence Compare your ideas to your ultimate goal to begin to identify ideas that are the most probable to achieve success Which idea or ideas are most likely to get you to your goal? Which idea is the simplest? Which idea is within budget? 6

7 DECISION MAKING STEP 5 Choose from the Alternatives Make the decision! DECISION MAKING STEP 6 Take Action Put your decision in motion When your decision involves others, don t forget to communicate and educate Step by step plans may be needed for very complex decisions Review DECISION MAKING STEP 7 Identify the specific things to measure to know if the decision is effective Measurements can be: Financial (revenue, expense) Time Error rate Satisfaction 7

8 STEP 7 REVIEW Back to our car example, you have weighed your options, pooled your resources and purchased your car.. What could you measure? Gas mileage? Repair costs? Cost savings from not taking the bus? There is only ONE right answer. MYTH #1 When your focus is overly narrow, you may miss an easy solution to your problem! MYTH 1 EXAMPLE FROM HISTORY In 1877, Thomas Edison founded the first record company (Edison Record Co.) and invented the phonograph, the first device made for recording and playback of sound World War II shortened the supply of materials Edison used for his highly secret wax recipe used to manufacture the records Though his lab company owned a patent on a new method of record production, he stubbornly asserted the wax process was the only right way to make records Because he refused to consider a new method, other companies seized the opportunity to make needle cut records, and Edison s record company was forced to close 8

9 MYTH #2 I need to be 100% sure. 100% certainty is a myth! People, problems, and decisions are complex, so certainty is not the goal; effectiveness is the goal! MYTH 2 EXAMPLE FROM HISTORY In 1908, Ford Motor Company produced the Model T and absolutely dominated the automotive industry By 1912, the company knew they needed to update the model; however, they hesitated, trying to be 100% certain that the new model would be successful In 1927, they finally upgraded the Model T and began work on the Model A, but their market share was down to just over 30% MYTH #3 If I don t make a decision, I can t be wrong. Not making a decision is really just a decision to not take action Instead, make the decision and act! Then, re-assess the effectiveness of the decision and adjust as needed 9

10 MYTH 3 EXAMPLE FROM HISTORY In the 1970 s, the Schlitz Brewing Company had the #2 best-selling beer In an effort to produce cheaper beer, they changed their production and formula Consumers widely disliked the new taste The company made a command decision to do nothing Sales plummeted and by 1981, the company closed its doors MYTH #4 I am too busy to stop and make this decision. Misplaced Priorities can happen in 2 ways: Not understanding the importance of acting/reacting quickly Spending too much time and effort in areas that are not vitally important to the success of the organization MYTH 4 EXAMPLE FROM HISTORY A courier brought a message to Colonel Rahl, a commander assisting the British during the Revolutionary War Rahl was busy and placed that message in his pocket without reading it When he finally read the message, it stated Washington was crossing the Delaware He rallied his troops, but it was too late and the resulting loss turned the tides of the whole war What was he so busy doing that he refused to interrupt.he was playing cards! 10

11 WHAT S MY TAKE- AWAY? Let s Practice! Think of a decision facing you right now Go through the 7 steps of the decisionmaking process as well as the barriers to verify that you are not stuck in 1 of those 4 pitfalls Has this presentation made you more comfortable and confident in your decision? QUESTIONS? Innovation and Excellence in Advanced Illness at End of Life The Carolinas Center s 42 nd Annual Hospice & Palliative Care Conference September 2018 Charlotte,,NC 11