A Model for Better Decision Making

When I was learning to fly, I learned quite a bit about decision making. One useful model I discovered is the DECIDE model. I think we use a similar, perhaps informal method, in clinical practice. It’s drilled into us in a subtitle manner in our training. It can work in clinical practice, however, when we begin process improvement initiatives having a model or checklist can help make your change easier and more effective.

1. Detect the change. Define the problem. The very first step is to detect that a change has occurred or a problem exists. Ask “What is the problem? What has changed?” If a change is to be recognized, proper monitoring must be in place. If you’re not monitoring for a change of any kind, it’s less likely you will discover it. Monitoring will help you identify if and when change is needed. A change might have occurred, but if you’re monitoring a process, you can see when and what you need to change to improve the process. You are aware of the fact that a change has occurred.
2. Establish the criteria. Estimate the response. After you’ve discovered a change has occurred, the need to counter or react to the change is the next step. Is this change significant enough that action is necessary? What will happen if the change isn’t addressed? What can we do to correct the change? What do you want to achieve? What do you want to preserve? What do you want to avoid?
3. Consider all the alternatives. Choose your course of action. The third step is to formulate a plan. Make a list of possible actions you can take to achieve a desirable outcome for success. How many possibilities are there to fix this problem? Which one is the best option? Which option will genuinely solve the problem?
4. Identify what went wrong. If you have a process in place and a change did occur, then you will want to identify which actions or steps which could have successfully prevented or controlled the change. Evaluate your processes and see what could have been done to avoid the change or problem. Get to the root cause of the issue.
5. Develop and implement a plan of action. Once you’ve found the problem, choose a course of action, and discovered what went wrong, take action. You must make the necessary effort to fix the problems. Implement your plan to correct for the change. How will you implement the plan? What resources are required?
6. Evaluate your decisions. The last step is often skipped. It is evaluating the effectiveness of your choices and actions. Keep track of the decisions you make and evaluate how they turned out. Don’t make a decision and then think about it again. Looking back and judging the outcomes will help give you the knowledge and make you a better decision maker.

The next time you’re facing a process improvement or need help in decision making, consider the DECIDE method to help you make better decisions.