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Decision Making Case Study

A cut is budgetary allocations translates into fewer resources to cater for the demands of the target population which in this case are Medicaid patients. To determine which services the clinic should stop offering or those it needs to introduce will require research into the type of services that are deemed essential and those that the target population can easily access elsewhere. This will entail framing the question in such a manner that it assists the decision maker in arriving at a decision.

Services that are high demand should be retained while those that are rarely requested for should be discontinued so that the population continues to get essential treatment. Expensive treatments for a select few will be reassessed on the basis of cost/benefit analysis since it is not justifiable to spend 50% of the Medicaid budget on say 7% of the patients. To establish the most appropriate decision, the manager should employ the informed decision toolbox (IDT) in gathering, assessing and applying the knowledge gained.

In framing the question to be answered by research findings, the decision maker must identify what metrics are to be measured or compared (Rundall, 2007). In this instance, it will be prudent to compare the performance of other county clinics faced with budget cuts and analyze what decisions they made concerning the type of services they opted to retain and those they did away with. It is important to identify the common ailments that afflict most people registered with Medicaid since their medical needs are different from those who can afford private health insurance.

This differentiation will inform the policy makers of the type of services that Medicaid patients are in dire need of. Eye and dental treatment may be ranked more important than cosmetic surgery. Based on these research findings, the decision maker can make an informed decision with regard to the range of treatments that will be available for Medicaid patients. Conducting a survey of Medicaid patients and asking them to fill out a questionnaire ranking the type of services they would like to see offered is another method by which research evidence can assist decision making.

The services picked as ‘most important’ by a majority of respondents will inform the policy maker about the right decision. The survey findings should include responses by respondents about services they would like to see introduced. Once again, the service requested by most of the respondents will assist the decision maker in arriving at an informed choice. A cost benefit analysis of the various services offered by the clinic and the frequency that patients require such services will inform the management of what measures to institute as part of the cost cutting activities.

Those services that are rarely required and have a high cost/benefit ratio should be eliminated to pave the way for the introduction of services that are in high demand. The decision maker will need to search for information from various sources so as to arrive at an informed decision. By researching medical journals, scholarly books and official publications, policy makers will gather important information which will guide them in making a final decision (Rundall, 2007). Trusted sites on the internet are a critical resource base for vital statistics and evidence based data which will compliment the researchers’ efforts.

Caution should be exercised in validating any information gleaned from various sources since author bias and editorial censorship may distort facts. Comparing data from different sources acts as a guide in establishing uniformity and accuracy in the findings. Incorrect data and poor assessments will lead to erroneous decisions that will be expensive to correct and difficult to reverse. Thus, the accuracy of any data is crucial in arriving at the best decision. Before implementing the favored course of action the decision maker should query whether the process can be localized with a measure of success.

It is important to verify the applicability of the research findings to the current situation (Rundall, 2007). This will entail an assessment of the various variables involved and how relevant they are in addressing the clinic’s dilemma. The research evidence should be actionable so as to resolve the challenges faced by the manger. Data that cannot be used to determine the best course of action is of little value to the decision making process. Managers should be able to determine if the information collated is sufficient to make an informed decision.

Viable options increase the range of choices the decision maker can choose from (Resnik, 1987). A limited number of alternatives may suggest that the research was insufficient and that more research needs to be conducted to establish the most appropriate action. Before a choice can be made, the manager should reevaluate the options and determine the opportunity cost of foregoing a particular choice (Kopeikina, 2007). This requires an analytical mind and critical assessments of the situation.

After conducting such an exercise, the manager can be confident that the best decision has been made employing evidence based research rather than colloquial evidence and subjectivity. Using the toolbox enhances accountability because decision makers base their decisions on irrefutable evidence obtained from reliable sources (Rundall, 2007). Discontinuing dental care in favor of providing mental health care for Medicaid patients may be informed by the fact that only 6% of the patients suffer from tooth ailments as opposed to 37% who require metal health care at some point of their life.

A decision like this is also subjected to the cost/benefit analysis which establishes the rationale for choosing one option over another. Unilateral decisions based on individual preferences are eliminated by the rigorous process of determining the right coursed of action. As a result of conducting research to come up with evidence backing certain decisions, the organization is able to build up a repository of information that can be disseminated and shared by all stakeholders.

This process enables the transfer of knowledge to persons within and without the organization and ensures a body of knowledge is available for all those who would like to research on various topics. The IDT assists management in creating a culture of questioning decisions within the organization (Rundall, 2007). Staffs are encouraged to give their informed input so as to solve pressing issues facing the institution. With regard to new ideas promoted by consultants and industry experts, the use of IDT enhances critical assessment and reevaluation of polices before implementation.

This contrasts with previous practices whereby health practitioners adopted new initiatives without questioning their efficacy or establishing the veracity of consultants’ claims. In conclusion, evidence based decision making processes achieve a much higher rate of success because they are dependant on factual information as opposed to subjective views and colloquial evidence. Managers are able to make the right choices by conducting research on the subject matter and subjecting the evidence to four tests namely; accessibility, accuracy applicability, and actionability.

It is on the basis of these evaluations, that the decision maker can make the best choice for the organization. References Kopeikina, L. (2007) The Right Decision Every Time: How to Reach Perfect Clarity on Tough Decisions. Pearson Resnik, M. (1987) Choices: An Introduction to Decision Theory. University of Minnesota Press Rundall, G. et al. (2007) The Informed Decisions Toolbox: Tools for Knowledge Transfer and Performance Improvement Journal of Healthcare Management 52:5

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