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Quality, decision-making and Organisational change

Q: What is the difference beween structured and unstructured problems?

Structured Straightforward and simple Clear goal Familiar problem Information is well- defined and complete --> Computer that breaks Unstructured New and unusual Unclear goal Unfamiliar problem Information is ambiguous and incomplete --> Most of the time it's something in between

Q: What is the difference between programmed and unprogrammed decions?

Programmed Repetitive decisions that can be handled using a routine approach Relies on previous solutions Decision- making process is much shorter --> Purchasing a new computer Unprogrammed Unique and non- recurring decision that requires a custom- made approach At the top level, most problems managers face are non-programmed --> New organisational strategy

Q: What is the difference between research and practice?

Research Deriving generalizable new knowledge or evidence that can be applied to healthcare Published in peer- reviewed journals Often a lengthy process --> Study a problem systematically, advance human knowledge Practice Studying problems focusing on organisation- specific knowledge Not peer reviewed Decision- makers need answers within a short timescale --> Solve today’s problems as soon as possible and move forward

6 important questions on Quality, decision-making and Organisational change

What is effectiveness? --> work evidence- based!

Provide services based on scientific knowledge (i.e., avoid under / over / misuse)

Underuse: failure to provide service which benefit is greater than its risk
Overuse: service is provided although its risk outweighs the benefits
Misuse: right service is provided badly – avoidable complications
--> most happening, giving the wrong amount of medication

Evidence-based medicine: Integration of best research evidence with clinical expertise and patient values
Many healthcare providers rely on tradition and anecdotal personal experience
Remember: Approx. half of all clinicians rely on clinical experience, not evidence

What is the difference beween structured and unstructured problems?

Structured

Straightforward and simple
Clear goal
Familiar problem
Information is well- defined and complete

--> Computer that breaks

Unstructured

New and unusual
Unclear goal
Unfamiliar problem
Information is ambiguous and incomplete

--> Most of the time it's something in between

What is the difference between programmed and unprogrammed decions?

Programmed

Repetitive decisions that can be handled using a routine approach
Relies on previous solutions
Decision- making process is much shorter

--> Purchasing a new computer

Unprogrammed

Unique and non- recurring decision that requires a custom- made approach
At the top level, most problems managers face are non-programmed

--> New organisational strategy

What is the difference between research and practice?

Research

Deriving generalizable new knowledge or evidence that can be applied to healthcare
Published in peer- reviewed journals
Often a lengthy process

--> Study a problem systematically, advance human knowledge
Practice

Studying problems focusing on organisation- specific knowledge
Not peer reviewed
Decision- makers need answers within a short timescale

--> Solve today’s problems as soon as possible and move forward

What is shared decision- making?

Bringing the information level of doctor and patient together to reduce information assymetry
--> Increasing the patient's information and control over treatment decisions
--> Improving the physician’s information about the patient so the best solution can be found

What is the three- phase change process?

Unfreezing
Changing
Refreezing

Problem: we need to be unfrozen the all time!
Revised view--> three- phase change process
1. Getting used to the change
2. Relearning
3. Becoming effective
Immobilisation--> denial--> depression--> letting go--> tasting new reality--> putting it together

The question on the page originate from the summary of the following study material:

Management and Innovation in the health sector

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