Effective Decision Making In Healthcare
Effective Decision Making In Healthcare
Introduction
The Medicaid program provides healthcare for people from relatively poor backgrounds. It enables low income earners to have access to affordable healthcare. A budget cut off by fifteen percent has several implications for this service provision. First of all, it may mean that some of services to clients may no longer be available to them. It may also mean that the services will be still available but at a higher cost than before. This will be a burden to the clients; their level of income will constrain them in accessing the relatively expensive services.
Therefore, a decision making situation arises; on what is the best action to implement which will be most beneficial to the clients of the Medicaid program. The decision making tool box provides six paramount aspects to consider in the process of making decisions. Step one involves framing the managerial question, step two involves finding sources of information; step three is assessing the accuracy of the information, step four involves assessing the applicability of the information, step five is assessing the applicability of the evidence and step six involves the determination of whether the information is adequate.
The decision making tool box
Rundall, Martelli, Arroyo, McCurdy, Graetz, Neuwirth, et al. (2007) provide the six steps imperative for effective decision making in health care. As the manager of a Medicaid program in a county clinic, I would first analyze the decision making problem using the six tools by the authors. The first tool to the decision will be framing the decision making situation to a managerial question. The managerial question here will be, due to the inherent budget constraint, which clinical services will I need to eliminate or introduce to the Medicaid program to meet best the needs of the health care program? Something out to be done for sure, given the low income of clients to the program, leaving the burden of the reduced funding to them would inhibit them from accessing the services because they will be relatively expensive considering their level of income.
This would lead me to step two in the decision making program which is finding sources of information. For this tool, I will analyze Medicaid service to look into the services it offers to the clients, to establish whether there are some I could eliminate without causing significant harm to users of the service; or to establish what I could introduce to the Medicaid program to keep pace with the cost constraints in the budget. I would ask my self, which services I could eliminate from the program and still foster the welfare of clients in the wake of the cost constraint.
The Medicaid program offers clinical services at relatively lower costs. It provides Medicare such as access to drugs at a cheaper cost. It offers other services such as health insurance premium payment for the clients. The HIPP service is a service that the clients could survive without, but they can not do without the relatively cheaper access to drugs. Therefore, I could eliminate the HIPP service and distribute the expenditures of the service to the other crucial services of the program such as access to cheaper drugs. I will also search the information available in the program database; to establish what dynamics I could introduce to the program to balance the cost constraint between the services of the program.
I would investigate the services to establish how the cost constraint could be shared effectively between the services. For example, I could increase the cost on non basic services and reduce the cost of the most basic services such as access to cheap drugs. Step three will be assessing the accuracy of the information that I use for step two. Is the information accurate enough to use in this decision making problem? I would use this step to analyze the available records in the program to assess whether it is accurate enough.
For example, I would confirm the authenticity of the entries to establish whether they relate directly to the actual situation in the program. An example, is the cost of the services offered to clients, does the records in the data base reflect the real cost of the services on the ground. This will enable me to establish with certainty whether I could rely fully on the information I intend to use for this decision making problem. In the fourth step, I would turn to the applicability of the information. Does the information apply directly to the decision making problem? In this stage, the emphasis is on using information which directly correlates to the question of the decision making problem.
The decision making problem in this situation is the cost constraint. I will assess the relevancy of the information to this case; the information I would use would apply directly to the problem because it would be on the costs of the services which the program provides to the clients. Cost of the services will provide a picture of cost distribution in the program, from which one could determine which costs he or she can eliminate as well as identify which dynamics he or she could introduce for the benefit of clients in the wake of the cost constrained due to cut down in budget allocation. Step five is assessing the workability of the evidence used for the decision making problem. The evidence in this case is valid for application to this case.
This is because it will be derived from the program’s database; it relates to the actual costs of the services. The decision making situation relates to the incorporation of the cost constraint in the provision of services such that the clients realize more benefits than costs from the decision. The final step in the decision making tool box is determining whether the information available for the decision making is adequate. The aim of this step is to ascertain that the information covers the decision making problem adequately. The information I would use for the decision making problem would be adequate; because all the cost centers in the program will be looked into, to establish the best way to absorb the cost constraint due to the cut down budget for the program.
The tool I find most paramount from the decision making tool box for this decision is the step five, which involves assessing the workability of the evidence used in the decision making problem. Evidence based practice is a paramount component of the clinical practice in today’s health care provision, Salisbury, Mar & Glasziou (2007). The decision making process must incorporate all the steps from the decision making tool box to be effective. The workability of then evidence is, however, the aspect of the tool box I find most crucial to the process.
Effective decision making can only result if the information used in the process provides enough evidence to support the decision arrived at, the decision must win support of the information. This will ensure that the decisions will not awry in the future, decision making without adequate detail to support is ineffective and may cause problems in the future when there is the application of the change in the program. Using the tool box impacts on the accountability, knowledge transfer and the questioning aspect in the organization; the tool box provides explicit steps that managers and leaders in health care institutions should follow to avoid arbitral decision making, Walshe & Rundall (2001).
Stakeholders in the organization can investigate the decision making process to establish soundness, and whether there is the use of due guidelines in the process, before implementation of the decision to avoid problems in the future. This ensures that there is accountability in the part of the decision makers. There is knowledge transfer because the decision is on the basis of an evidence based practice. The changes I would introduce in the program to cater for the reduction in the budget would include cutting down on expenditures of unessential services such as HIPP, there will be channeling of the expenditures previously on the avoidable services to more basic services of the program such as access to cheap and affordable Medicare. This will ensure the fifteen percent reduction in the budget of the program does not adversely affect the low income earners.
References
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