Decision Making Case Study Stefanie Parker HCS/514 June 24, 2011 Kendra Slatton Decision Making Case Study The standard definition of decision making is; the process of mapping the likely consequences of decisions, working out the importance of individual factors and choosing the best course of action to take (“Definition of decision,”). In this case study effective decision making tools will be used to choose the best course of action to take in the scenario. The scenario is; as a manager in a county clinic that provides care to Medicaid clients, your department budget was recently cut by 15%.
From a statewide health policy standpoint, given a defined budget constraint what clinical services should be eliminated or introduced to best address healthcare needs of a Medicaid population. Rundall et al developed a tool they call the Informed Decisions Toolbox or IDT, which they suggest will help make better evidence-informed management decisions. Evidence-informed decision-making is the process of gathering and analyzing the best evidence available and making an informed decision based on that knowledge (National Collaborating Centre for Methods and Tools [NCCMT], n. d. ).
The process of evidence-informed decision-making involves six steps. Each of these six steps can be used as a tool for improving decision-making. The six steps include framing the question, finding sources of information, assessing the accuracy of the evidence, assessing the applicability of the evidence, assessing the “actionability” of the evidence, and determining if the information is adequate (Rundall et al. , 2007). As manager of this case study clinic, I would find these tools very valuable in determining which services to add or remove to meet the budget goal of the organization.
These steps form a process or a checklist of action items for reaching an informed decision. The tool that would be the most valuable to me as the clinic manager would be step number two; finding sources of information. Performing research can be time-consuming and difficult, but it is the heart of any good decision. Using this tool, I would be able to find evidence of past successes or failures in similar healthcare budget cuts. Research could determine the priorities of the Medicaid community and the care that is the most important to them.
Collecting data on efficiency statistics may allow the organization to keep important services by improving process flows and reducing waste. Some of the research tools include interviews, academic journals, data warehouses, and the Internet (Rundall et al. , 2007). The steps following the research collection, which include evaluating the data and taking action are also very important but are only as valuable as the data used for those steps and tools.
Based upon the surveys, interviews, and research done the clinical services that would be eliminated during the budget constraints would be; the community-based weekend and after hour’s clinic for Medicaid patients who do not have a primary care provider as well as putting a cap on the number of Medicaid patients that the clinic will see. The clinic generally is losing money and has been subsidized by other services. The recommendation would be to eliminate the weekend hours, which would reduce our spending at the clinic because of a reduction in staffing.
Putting a cap on the number of Medicaid patients that the clinic will see will help with expenses as Medicaid has low reimbursement rates, and the clinic is not receiving enough money back on these patients to pay for the expenses of seeing them. A manager using any of the tools in the IDT should be aware of the impact his or her decisions have on the organization and community. The use of these tools will enhance the clinics ability to better understand their Medicaid clients and how their decisions will affect the lives of those individuals.
This knowledge helps foster accountability to those groups because the clinic has acknowledged their needs and should act on them appropriately. Part of using the Toolbox is sharing the information gathered from research. This is an important part of the process because it helps everyone make more informed decisions within the organization as well as external sources. The most important outcome from using the Toolbox is creating an environment of constant learning and improvement. A manager using the IDT as part of the business strategy will consistently seek out ew information on how to improve the organization that drive more informed and successful decisions. Using the IDT, managers can make effective evidence based decisions that will benefit the organization. In this case the tools were used to make an effective evidence based decision to cut Medicaid services in a time of budget constraints. References Definition of decision making. (n. d. ). Retrieved from http://www. decision-making-confidence. com/definition-of-decision-making. html Health-evidence. ca. (n. d. ).
Tools to support evidence-informed decision making. Retrieved 1/17/2010, from http://health-evidence. ca/tools National Collaborating Centre for Methods and Tools. (n. d. ). Evidence-informed public health. Retrieved 1/17/2010, from http://www. nccmt. ca/eiph/index-eng. html Rundall, T. G. , Marte, P. F. , Arroyo, L. , McCurdy, R. , Graetz, L. , Neuwirth, E. B. , Curtis, P. , … Hsu, J. (2007). The informed decision toolbox: Tools for knowledge transfer and performance improvement. Journal of Healthcare Management, 52(5), 325-342.