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ISLAMIC MEDICAL EDUCATION RESOURCES 04

39.5 DECISION-MAKING AND PROBLEM-SOLVING, al qaraaraat wa al mashaakil

By Professor Omar Hasan Kasule Sr.

39.5.1 PRINCIPLES OF DECISION MAKING

Leaders and managers make strategic, tactical, or operational decisions. Programmed decisions are routine procedures and un-programmed decisions are creative, innovative, and risky. Major decisions are best taken incrementally. Certainty is better than uncertainty. Easier alternatives are preferred. Discussions improve decision making. Best decisions address needs and not want and require time. Scientific decisions are better than hasty or prevaricative decisions. Decision making can be rational systematic, intuitive, mathematical or statistical. Consensus is better than majority decisions. A competent individual decision is better than that of a majority of average individuals. The worst decision is that by an average individual.

 

39.5.2 PROCESS OF DECISION-MAKING

All possibilities are considered and the larger picture is visualized while putting the decision in proper context. Review of previous related decisions helps. An assessment is made whether a decision is necessary. A bad decision is stopped before making a better one. The degree of risk and uncertainty must be known. The present decision must be related to others. Biases are acknowledged. Implementability must be considered. The issues must be classified as to importance and urgency. Assumptions and forecasts are made. Available resources are considered. Decision alternatives are generated and the best alternative is selected. The future impact of the decision is analyzed. Then istikhara is carried out before decision implementation. A bad decision should be changed sooner than later.

 

39.5.3 PRINCIPLES OF PROBLEM-SOLVING

A problem exists if reality is different from the expected. Problems should be identified early in the lag time between cause and consequence. Problems are challenges and opportunities that should be approached with an open mind and viewed as holistic. Problems are solved and not shifted around. It is better to leave a problem unsolved if the consequences of the 'best' solution are worse than the original problem. An optimal solution will produce maximum effect from minimum effort. Cumulative experience cannot solve all problems. Fixed tested procedures solve routine and emergency problems but not creative new problems. Decision audit is educative. 'Best' is not synonymous with the simplest solution. Quality solutions can be arrived at by generating a lot of alternatives and selecting the best proving the rule that quality is from quantity.

 

39.5.4 PROCESS OF PROBLEM-SOLVING

Problem solving is realistic appraisal, seeing problems as challenges and opportunities, open mindedness,, toleration for alternatives, the realization that 'different' is not 'wrong', encouraging 'strange' ideas, combining and extending ideas, creativity, and persistence. Stages of rational systematic problem-solving are: analysis of the environment, recognition of the problem, identification of the problem, determination of the ownership of the problem, definition of the problem, classification of the problem, prioritizing the problem, collection of information, making assumptions and forecasts, generating decision alternatives, pause during incubation period that leads to illumination, selection of the best alternative, analysis of the impact of the chosen alternative, implementation, control of the implementation,  and evaluation of the results. Barriers to effective problem solving are wrong concepts, attitudes, behaviors, questions, and methods. When you have an overwhelming problem, talk to someone who can listen. De-emotionalize the problem. Look at problem from wider perspective. Identify positives in the problem. Solve the problem systematically. Do not escape/avoid, do nothing, scream, self-anesthesia, or lament.

 

39.5.5. MANAGEMENT OF CRISES

A crisis is a situation of a major change with potential risk. A crisis, preventable and non preventable, is always waiting to happen. Crises are opportunities for creative problem solving. A crisis is a fluid, dynamic, and fast condition associated with fear and interferes with normal life. It goes through 5 stages: prodroma, acute crisis, chronic crisis, and crisis resolution with ripple effects. Crisis management reveals organizational weaknesses and strengths. Strong organizations have mechanisms to forecast crises, contingency plans, and worked-out worst-case scenarios. They can detect prodromal signs before a crisis. Crisis management involves reversing prodromal signs and intervention to deal with after-effects. The crisis intervention strategy includes identification of the crisis, isolation of the crisis and management of the crisis. Decision making in a crisis is stressful.

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