Leadership decision-making and process improvement

A multi-faceted solution that includes an evidence-based process and a transparent method to execute that process is critical for making good decisions.

By Dee Donatelli

Healthcare reform, and now a pandemic, has mandated an evolution in care delivery. Quality and value have taken on a more well-defined meaning. No longer is a focus on costs enough. Leaders must be concerned with delivering high-value care. This task requires improving processes and reducing costs without sacrificing outcomes.

Making decisions to achieve value is rarely simply. Complexity is the norm, and cognitive burden is high. Participants in the process sometimes have varying perceptions of the goal that is trying to be achieved, as well as a conflicting understanding of the trade-offs that exist between alternatives. Here lies the burden of balancing quality, overall cost, and outcomes.
In order to be consistently successful in making good decisions, a multi-faceted solution that includes a robust, evidence-based process and a transparent, efficient method to execute that process is mandatory. It requires developing a process that coordinates time, resources, and decision-making criteria; and then operationalizing the process in an integrated, transparent, and efficient manner.

At the time of this writing, much of our workforce is operating remotely. Unfortunately, due to the lack of a standardized decision-making criteria and workflow process, it has become increasingly difficult, if not nearly impossible, to make good decisions that include key stakeholders. Whether your decision is for physician preference items, a capital purchase, a new clinical initiative, or an evaluation of purchased services, your assessment should be data-driven, and allow your stakeholders to have the information they need to arrive at smarter insights, faster.

What to consider

The pandemic has allowed a forgiveness of sorts and clinicians have tolerated a “pause” in elective decision making. Moving forward a consistent, multi-faceted solution that will work under any circumstance must become a standard way of doing business. Let us consider some key elements leaders should consider in advancing standardized and enhanced decision making. 

  • Leaders must create and enable a virtual decision-making workflow process to include key stakeholder’s vs a traditional committee member structure.
  • Leaders must continue to move decision making from subjective to objective. Nice to have vs need to have should become the new criteria.  
  • Leaders must create a process workflow that is transparent and inclusive. Task-focused steps in process workflow will keep initiatives on target and on schedule. 
  • Leaders must provide accurate, applicable, actionable, and available data. Decisions must be based upon facts not feelings. 
  • Leaders must integrate evidence and data seamlessly into the decision-making process.
  • Leaders must create a process which supports complex decisions by providing critically appraised and fiercely unbiased evidence. This information must be “consumable” meaning in an executive summary and easily understood. Full reports should be available upon request but not bog down process decision making. 

Finally, there are multiple industry challenges in healthcare, one of which is how to attain value in the care delivered. This entails looking beyond cost, and asking “how does the item, process, or technology that we are evaluating add value to our patients, beyond the short term?” This will require addressing questions related not only to price, but utilization, standardization, and variance across consumables, capital, purchased services, processes of care, and clinical and strategic initiatives, including what is important to the patient. 

Leaders have a responsibility to improve the process of decision making in their organizations. Considering some of the listed key elements is the basis upon which to improve operations. Moving from traditional operations to a virtual platform with enhanced expectations of participants and a standardized application process is critical in today’s ever-changing work environment.

Dee Donatelli, R.N., CMRP, CVAHP, has more than 40 years of experience in the healthcare industry as a registered nurse, supply chain executive and consultant. Donatelli has held leadership positions in hospitals, consulting firms, distributors and GPOs. Donatelli is a past president of the Association of Healthcare Value Analysis Professionals (AHVAP) and is the current Chair of the Association for Healthcare Resource and Materials Management (AHRMM). An Bellwether Class of 2015 inductee, she also serves on Bellwether League’s Board of Directors. Donatelli currently serves as VP of Professional Services at TractManager and as Principal, Dee Donatelli Consulting, LLC. She can be reached at Dee@DeeDonatelli.com.