If a healthcare organization does not properly identify and manage their critical decisions, then this can lead to big problems for everyone.

Here is a case study:

A 65 year old patient was found to have a large mass near the bottom of his esophagus (food tube). At the same time, it was discovered that he had aortic stenosis ( a tight aortic valve). Because of the aortic stenosis, the operation to remove the esophageal mass was delayed.

About five months later, the cardiologists finally made a decision that the surgeons could operate. Unfortunately, it was too late because the esophageal mass had become inoperable.

This hospital needs an immediate solution for the unacceptable delays with critical decisions. They fail to stratify decisions into critical and non-critical. They don't use a decision hierarchy.

There is an imperative for this hospital to improve their decision processes and their decision architecture.

They should start by developing a work flow that clearly articulates which decisions are critical and non-critical. They should set up a process that includes a deadline for each critical decision. Timelines help!

They should map the steps taken with their decision making for both critical and non-critical decisions. It is important to identify those elements that block effective decision making and to streamline the process. And they need to establish measures to track decision effectiveness to answer the question about whether they are good or bad decision makers.

A focus on decision effectiveness can help to transform the organization's culture. The focus must be on defining what decisions need to be made, who will play a role in making the decisions, when will the decisions be made and what kind of processes will be used to make the decisions.