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Results for “Decision Making, Organizational”

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At least 19 recordsLinked to original sources
PubMed2005

Promoting participation in organizational decision making by clients with severe mental illness.

This qualitative study assessed clients' participation in organizational decision making in a public long-term psychiatric hospital. Numerous examples were found in which clients meaningfully participated in the decision-making process and achieved favorable policy changes. Three means of involving clients were found to be especially useful: (1) using a consumer council, (2) involving clients in the formal policy review process, and (3) including clients in the hospital's performance improvement system. The authors offer guidelines for mental health organizations wishing to promote client participation in organizational decision making. Implications for social work are discussed.

Adult↗
PubMed2001

Intensity of case managers' participation in organizational decision making.

Prior research has indicated that registered nurse (RN) participation in decision making (PDM) is related to better outcomes in nursing homes and hospitals. Little is known, however, about the roles of community-based case managers (CMs), most of whom are RNs. Data from 68 prenatal case management programs were used to test hypotheses about the intensity of CM PDM and to describe their patterns of involvement in decision activities and mechanisms. CMs were most involved in the activity of "raising the issue" and least involved in "choosing the alternative." However, "choosing the alternative" was the strongest predictor of perceived CM influence over the final choice. When CMs were involved in informal meetings and chance encounters with administrators, they were more likely to be perceived as having influence over the final choices made. Intensity of CM PDM varied by decision level and content, supporting two of the three hypotheses. The findings are discussed in light of prior research and complexity theory.

Adult↗
PubMed1999

RN participation in organizational decision making and improvements in resident outcomes.

In the study on which this article is based, nursing homes with the most improvements in resident outcomes had greater registered nurse (RN) participation in decision making than did homes with the least improvements. The results suggest that nursing homes that want to improve quality can use RN participation to make improvements without significantly increasing costs. Complexity theory served as a framework for the study.

Decision Making, Organizational↗
PubMedDate not supplied

Effect of hospital conversion on organizational decision making and service coordination.

This study looks into the "black box" of hospital ownership conversion in a "natural experiment." We posed two competing theories about how conversion might influence management practices. Results support complexity theory and not threat-rigidity theory. As predicted from complexity theory, MDs and RNs had greater levels of participation and influence over final decision choices in converted hospitals than in nonconverted hospitals.

Decision Making, Organizational↗
PubMed1995

[Organizational decision making in health: the case of dengue].

Intelligent organizations (IO) represent a valuable tool to organize and guide dengue fever surveillance, prevention and control interventions. IO entail state of the art technology in managerial science to generate behavioral frameworks of organizational structures and policies. They present a systematic description of problems and construct computerized models to develop systemic thinking; they produce a shared vision and build progressive mental learning and advancement models. Also, IO promote team building and personal control skills. Scientific-technological advances have produced a wealth of information in medicine, with the corresponding growth of organizations and difficulty of responses because of sudden and incessant change. This new environment calls for the application of IO know-how. This article is oriented to prove the usefulness of the IO technology in the ordering and systematization of the reports about the medical sciences facts. Dengue was chosen to exemplify the use of IO technology as it represents an increasing health problem in America, as well as in Mexico; it is so complex that it can evolve to a more serious problem, besides it can be analyzed within a systemic method.

Aedes↗
PubMed1983

Professional participation in organizational decision making: physicians in HMOs.

Although it has been suggested that participation by physicians in administrative and policy decisions is linked to outcomes in health care organizations, there is little research on this subject. Using Shortell's framework this paper considers relationships between perceived participation and three intermediate organizational outcomes: physician work satisfaction, perceived staff consensus about day-to-day activities, and attitudes toward patients. Also considered are situational, professional, and personal characteristics which may be related to participation. Data were collected from four staff model health maintenance organizations (HMOs) in 1978 and 1979 through physician questionnaires, administrator interviews, and documents. Physicians who reported greater participation were more satisfied with work, perceived greater staff consensus, and had more favorable attitudes toward patients. Greater participation was associated with full-time employment status and more years in the HMO (but not with the physicians' professional or personal characteristics). Implications of these findings are discussed, and it is proposed that the findings suggest mechanisms by which participation in organizational decision making may affect ultimate outcomes of the organization.

Attitude of Health Personnel↗
PubMed2001

The involvement of a consumer council in organizational decision making in a public psychiatric hospital.

This article describes a consumer group within a public psychiatric hospital that serves primarily a forensic population. Some barriers to participation included the severity of some clients' mental illness, an organizational culture that does not fully support participation, the lack of clients' awareness of problems or alternative actions, and inherent power imbalances between clients and staff. Despite these barriers, the consumer group has made improvements for facility clients. Some factors associated with this success included strong administrative support, the allocation of a highly qualified staff liaison to work with the group, and the integration of the group into the facility's formal decision-making structure. Lessons are offered for the development of similar groups within public psychiatric hospitals and community-based mental health agencies.

Commitment of Persons with Psychiatric Disorders↗
PubMed1983

Diagnosing organizational decision making through responsibility charting.

Decision making within many organizations is becoming increasingly complex and difficult to manage. This article describes a technique called "Responsibility Charting" which can be used as a basis for understanding and improving decision making, and for enhancing the quality of communication within an organization. The authors present a case study to illustrate the types of analyses possible with this technique.

Administrative Personnel↗
PubMed1988

Understanding organizational culture: a key to management decision-making.

Organizational culture is a significant element in today's health care environment. Understanding work culture can assist the nursing administrator in hiring personnel, orienting newcomers, facilitating organizational change, and promoting learning. The authors report a study that identified the work group culture of two nursing units and suggest that differences between these cultures affect a variety of nursing administration decisions.

Administrative Personnel↗
PubMed1989

In search of rationality: the purposes behind the use of formal analysis in organizations.

This paper describes the results of a study that examines how formal analysis is actually used in practice in three different organizations. Four main groups of purposes for formal analysis--information, communication, direction and control, and symbolic purposes--are identified and related to the nature of the social and hierarchical relationships between those who initiate analysis, those who do it, and those who receive it. It is concluded that, far from being antithetical as often assumed, formal analysis and social interaction are inextricably linked in organizational decision making and that different structural configurations may generate different patterns of use of analysis.

Communication↗
PubMed1984

Mingling decision making metaphors.

Organizational decisions provide conceptual playing fields wherein scientists adhering to rival theories based on different metaphors skirmish in-decisively. Organizational decisions, however, are also empirical arenas wherein practitioners espousing discordant theories-in-use reconcile their differences pragmatically. Practitioners' decision-making metaphors encountered while studying capital budgeting suggest how disjoint perspectives are assimilated and shifts from instrumental to symbolic actions are triggered. Implications for decision theories are discussed, and potential benefits of incorporating practitioners' knowledge into organizational science are considered.

Budgets↗
PubMed1997

Empowerment and staff nurse decision involvement in nursing work environments: testing Kanter's theory of structural power in organizations.

Work redesign initiatives have transformed approaches to patient care that will require increased control of nurses over both the content and context of their practice. A secondary analysis of two studies linking perceived work empowerment with two aspects of staff nurse decisional involvement using Kanter's (1977, 1993) theory of structural power in organizations is described. In these studies, the pattern of relationships among variables in Kanter's theory and two different facets of work decisional involvement (control over the content and context of nursing practice) were examined using structural equation modeling techniques. Consistent with theoretical expectations, perceptions of formal and informal power significantly influenced perceived access to work empowerment structures. Informal power was found to mediate the relationship between formal power and access to work empowerment structures. Formal and informal power and access to empowerment structures, in combination, were found to be significant predictors of the extent of involvement in decisions related to the content and context of nursing practice, respectively. The results provide empirical support for propositions derived from Kanter's theory of work empowerment, and provide potential guidance for theory-based management practices to enhance nurses' involvement in professional and organizational decision making.

Adult↗
PubMed2006

Understanding the emotional aspects of escalation of commitment: the role of negative affect.

Despite the importance of understanding the emotional aspects of organizational decision making, prior research has paid scant attention to the role of emotion in escalation of commitment. This article attempts to fill this gap by examining the relationship between negative affect and escalation of commitment. Results showed that regardless of whether negative affect was measured as a dispositional trait (Neuroticism) in Studies 1 and 2 or as a transient mood state in Study 3, it was negatively correlated with escalation tendency when one was personally responsible for a prior decision. This pattern of results is consistent with the predictions derived from the coping perspective, suggesting that people seek to escape from the unpleasant emotions that are associated with escalation situations.

Adolescent↗
PubMed2000

Do we face a fourth paradigm shift in medicine--algorithms in education?

Medicine has evolved toward rationalization since the Enlightenment, favouring quantitative measures. Now, a paradigm shift toward control through formalization can be observed in health care whose structures and processes are subjected to increasing standardization. However, educational reforms and curricula do not yet adequately respond to this shift. The aim of this article is to describe innovative approaches in medical education for adapting to these changes. The study design is a descriptive case report relying on a literature review and on a reform project's evaluation. Concept mapping is used to graphically represent relationships among concepts, i.e. defined terms from educational literature. Definitions of 'concept map', 'guideline' and 'algorithm' are presented. A prototypical algorithm for organizational decision making in the project's instructional design is shown. Evaluation results of intrinsic learning motivation are demonstrated: intrinsic learning motivation depends upon students' perception of their competence exhibiting path coefficients varying from 0.42 to 0.51. Perception of competence varies with the type of learning environment. An innovative educational format, called 'evidence-based learning (EBL)' is deduced from these findings and described here. Effects of formalization consist of structuring decision making about implementation of different learning environments or about minimizing variance in teaching or learning. Unintended effects of formalization such as implementation problems and bureaucracy are discussed. Formalized tools for designing medical education are available. Specific instructional designs influence students' learning motivation. Concept maps are suitable for controlling educational quality, thus enabling the paradigm shift in medical education.

Algorithms↗
PubMed1997

Conducting unit-based research to improve quality of care.

How does a tertiary care medical center without a primary academic nursing affiliation improve quality of patient care by conducting unit-based nursing research? The organization's strengths and opportunities include top management support, an infrastructure for development of nurse researchers, a specific patient care coordinator role, research supporting organizational decision making, and success in obtaining nursing research grants. The effects of limited consultative support, statistical avoidance, reorganization, competing staff demands, and lack of funding must be minimized. Strategies include: continue communication with top management, provide meaningful development opportunities and technical research support, build on completed research, use multidisciplinary teams, and change thinking to maximize the research opportunities that already exist.

Chicago↗