Decision Making in a Complex Environment

As learning leaders, critical thinking skills have always been an essential aspect of your skill set.

Most health care professionals did not go to school to be IT managers. Yet, increasingly, most health care organizations’ projects and operations are IT-dependent, or have an IT component. This fact, combined with the inherently complex nature of health care in general — rapidly emerging treatments and medications, myriad stakeholders and partners, high-risk situations, federal regulations, etc. — creates one of the most complex environments in which to make, and implement, decisions.

For most health care executives, work revolves around solving problems. Given the complexity of the health care environment, it is critical to apply a structured approach to identifying and solving problems, as well as making the right decisions to move forward.

As learning leaders, critical thinking skills have always been an essential aspect of your skill set. However, the innovative thinking required for developing creative solutions managing multiple stakeholder expectations and conflicting requirements often can be elusive. Using methodical approaches to analyze problems and opportunities not only can help ensure correct root-cause diagnosis of your problem, but also can give you the ability to generate a number of innovative responses from which to select a solution.

In day-to-day business, we often get in a rut that confines thinking to what’s worked well in the past or we simply don’t take the time and effort required to do things right. To make truly good decisions, one needs to actively apply different thought styles to tackle different types of activities and tasks.

A continuous mentality shift is fundamental. You also should understand the following five different types of thinking, be able to determine which type is appropriate and be able to apply each in various situations:

— Strategic thinking.
— Tactical thinking.
— Analytical thinking.
— Critical thinking.
— Implicative thinking.

In using different types of thinking at different points in your processes, you will yield a wider range of plausible response options and, ultimately, better decisions.

Analytical thinking begins with asking such questions as: Is there a problem or opportunity? Why does the problem or opportunity exist? What is the root cause of the problem or opportunity?

Strategic thinking begins with asking such questions as: What is the “big picture” for the organization? Where are we trying to go? What is our long-range plan for getting there? How will this problem hinder us from getting there? How will this opportunity help us to get there? Should we address this problem or seize this opportunity and is it worth our time? Strategic thinking can hone your ability to determine on what your organization should expend its resources. Considerations should include ultimate benefits such as increasing revenues (funding), learner satisfaction (quality) and returns (efficiency).

Innovative thinking begins with asking such questions as: Is there a different way of looking at this problem or opportunity? What innovative approach could we take to this problem or opportunity? What collaborations or partnerships might we consider? This often is referred to as “thinking outside the box.” Again, it’s wise to use tools to prompt this type of thinking.

Implicative thinking begins by asking such questions as: What would happen if we proceed with option A? Option B? Option C? This is systems thinking. The implications of all alternatives must be considered before converting them into action. It’s only once you have thoroughly explored the possible outcomes of different approaches that you can be confident you’ve made the right decision. Prioritization matrices and pair-wise comparisons are useful tools for implicative thinking.

Finally, tactical thinking begins by asking questions such as: What actions do we need to take to solve this problem? What actions do we need take to seize this opportunity? This type of thinking focuses us on the specific actions required to achieve the agreed-upon strategies. (Too often, we move into tactical thinking before we’ve adequately thought through a problem or made a hasty decision.) When determining tactics, it is important to be clear about time frames, results and how success will be measured.

Applying these different thinking styles is not easy, and it takes time to use them. But imagine an organization that applied analytical and strategic thinking to correctly diagnose a core problem and, as a result, was able to correctly identify project scope at the beginning of the project. And what if a structured decision-making process — where innovative, implicative and tactical thinking were applied — was used and documented, including alternative solutions, decision-making criteria and rationales for selecting particular actions?

That organization’s ability to keep its project on track amid the inevitable staffing changes, shifting resources and changing landscape is much improved over an organization that does not apply these methods. Using a structured approach to solve problems helps ensure the right decision is made — ultimately improving both your performance and the performance of your organization.