1. Definition of problem Unintended and unsatisfactory situations (something going wrong) Some deviation from the expected standard which prevent the achievement of objectives. A present unsatisfactory state that needs to be changed to a desired state as soon as possible. Problem is or 1

2. Definition of Problem Solving It is a thought process in which a person use information in making judgment about a particular event. It is a thought process in which a person use information in making judgment about a particular event. 2

3. Definition of Decision Making It is a cognitive systematic, sequential process of generating and evaluating alternatives, and making choice among them, putting the choice into action to meet desired goal. 3

4. Identify the problem Develop alternatives Evaluate alternatives Choose and implement the best alternative Evaluate the decision Internal Environment 4 Decision Making process

5. Decision – Making Requirements Decision – Making Requirement s Alternatives Decision maker Payoff relationships States of nature Problem content 5

6. Factors Affecting Decision Making Routine versus no routine decision Lack of creativity Implicit favorites Time available Risk associated with the decision Degree of acceptance and support organization attitudes toward decision making Amount and kind of information available Manager’s personal ability Critical nature of work Tunnel vision Written guidelines Factors Affecting Decision Making 6

7. Decision making and problem solving techniques

8. Brainstorming: The idea generating technique wherein a number of persons present alternatives without regard to questions of feasibility or practicality. Through this technique, individuals are encouraged to identify a wide range of ideas. Usually, one individual is assigned to record the ideas on a chalkboard. Brainstorming may be used at any stage of the decision- making process, but it is most effective at the beginning, once a problem has been stated. Brainstorming is most effective for simple, well-defined problems. It encourages enthusiasm and competitiveness among group members in generating ideas. It also prevents group members from feeling hopeless about the range of possibilities in a given situation. 7

9. The decision tree: All factors considered important to decision can be represented on a decision tree. A decision tree may be viewed as a mean of organizing the key elements that go into a decision, thus a decision tree is a graphic tool that allow the manager to identify the alternative solutions to see what factors need to be considered, and to look at the probable outcomes The manager is given all the pertinent data, which are then plotted on a tree. Each alternative is plotted as a branch on the tree, which is then divided into sub-branches that identify critical factors to be considered. Risk factors can also be added. The size of the tree and the number of branches depend on the resources and number of persons involved and on how critical the decision may be. 8

10. STEPS IN NOMINAL GROUPING Statement of the problem Idea generation Final ranking Round-robin recording Clarification of ideas Preliminary voting Discussion of Revised list 9

11. STEPS IN THE DELPHI TECHNIQUE Problem presented (questionnaire) Results compiled, distributed Second (and subsequent) questionnaire (s) completed Consensus 10

12. Fishbone diagram Problem Equipment PeopleProcedures Policies Cause Effect 11 Categories of possible causes to be analyzed Reasons why the problem occur or continues

13. 11 Fishbone diagram Delay lab. Results for emergency Dep. Equipment PeopleProcedures Information system Broken Unavailable No information available Insufficient specimens Patient High volume of work Delay in producing requisition Ability to draw the sample Cause Effect Improper preparation Nursing staff

14. 0 5 10 15 20 25 Inflexible scheduling Better job offer Personal relocation Excessive workload Difficulty with coworkers Difficulty with manager Nurses’ Reported Reasons for Leaving Hospital Employment Parito chart Nurses’ Reported Reasons for Leaving Hospital Employment Parito chart

15. Flow Chart Beginning or ending steps Step in the process A Decision point Written document Flow lines Used Symbols 12

16. EXAMPLE MD prescribes feeding Tube insertion Available On unit Clerk notifies nurse Nurse assembles supplies Order supplies From central stores of a detailed flowchart Clerk transcribes No Yes 13

17. Supplies available Supplies transported To unit Nurse notify MD Nurse goes to Patient room Nurse explains To patient Nurse measures for Tube placement, Assesses patient No Yes 14

18. Difficulty in Passing tube Nurse inserts tube Using good technique Assess for placement Tube in Stomach Secure the tube Continued difficulty Remove and reinsert Once or more Call for expert assistance Continued difficulty Notify MD Tube in stomach Pull back on tube Remove tube No Yes No Yes 15