Evidence Based Decision Making

Most of us have to make decisions from the time we wake up until the time we go to bed at night. Answering questions like what should I eat for breakfast, can I make that yellow light and should I go to the gym or go out for pizza all require us to make a choice or a decision (Robbins, S.P., Judge, T.A., 2009). At work I am challenged with collaborating with managers and other leaders to make decisions based on scenarios and events that occur in the hospital.

Decision making biases played a devastating role in the Deepwater Disaster. The biases that were present are; representativeness heuristic, overconfidence bias, confirmation bias and escalation of commitment bias. Based on my findings, to some extent, each of the following biases contributed to the Deepwater Disaster.

Evidence-based practice is extremely important in health care. It is not only important to know how to perform a certain skill, but why it should be done. There needs to be a standard of care and providers need to know the best way of doing things based on evidence. The article mentions that in the 20th century, many medial decisions were made on doctor assessment and preference (Brower, 2017). Many physicians were practicing dramatically different when compared with one another, which led to the realization that changes needed to be made and Evidence-based practice began to develop. Even though Evidence-based practices have been in play for a while, there is a gap between understanding and applying evidence-based

According to Warren et al. (2016), numerous barriers exist for implementation of evidence-based practice (EBP) within hospitals. In a study conducted evaluating the strengths and opportunities for implementing EBP in hospitals, lack of autonomy, lack of leadership support, and lack of inclusion in clinical practice decisions, were noted as the top barriers to the implementation of EBP (Warren, et al., 2016). The study revealed that while the majority of respondents’ beliefs

Decision-making in the workforce is a process of responsibilities used by upper management to implement, enforce rules, regulations, and maintain a successful environment. Decision-making implemented more effectively by making a plan, thinking it through, accepting more than one opinion and determining what is best. However, decision-making often utilized more effectively by opening doors of opportunities for a suggestion, question, discussion, and feedback. Although, more involvement helps improve understanding, utilize behavior skills and present opportunities for better communication. Everyday life consists of decision-making, the right decision may not always be applied, but ensure room for improvement and opportunity. Individuals approached decision-making in many different ways. As stated by (Jones, Graham, & Bateman, 2006) decision making is a procedure used to recognize a problem, weigh the alternatives and evaluate a solution in which, certain situations will require different approaches to become effective.

Evidence-based practice is the practice of making clinical decisions based off the best available research evidence coupled with the nurse’s own expertise, while also taking into account, the patient’s assessments and own personal preferences. This use of research has proven effective at providing better outcomes and lower healthcare costs, yet there are several barriers, such as time, education, and support, which prevent nurses from consistently using evidence-based practice (AJN, 2012). The top three barriers to the use of evidence-based practice are lack of time, education, and support in implementing new practices and using them consistently.

The research question I have chosen to investigate is “In what ways can we agree that the town of Brentwood, England, is a sustainable area?”

Evidence base practice is essential in nursing practice. It incorporates 3 key components which are clinical expertise, patient values, and best research evidence in order to provide the most effective and safe decision making for patient care. Neglecting a key component can affect the accuracy and efficiency of a research. Clinical expertise is based on a clinician’s experience, skill, education level and understanding in a certain area of nursing practice. Patient values can impact evidence base practice depending on their needs, preferences, expectations, values, understanding, and concerns. Best research evidence can be obtained from clinical research with supporting evidence base literature and sound methodologies. Each component will be discussed in further detail and how it links to clinical decision making by registered nurses in order to achieve the best evidence-based practice available.

In the text, Kreitner and Kinicki (2013) states that decision making is one of the primary responsibilities of a manager, and the quality of one’s decisions can have serious consequences. As the title of this cause study shows Faulty Decision Making is the Cause of the Deepwater Horizon Disaster. Faulty decision making or lack of any decision making is the key to this disaster.

The evidence hierarchy is a ranking that distinguish the types of research evidence based on the strength of the evidence itself (Polit & Beck, 2012). It is mostly applicable to the research questions regarding the effects of clinical interventions. The evidence that are ranked based on the evidence that uses appropriate research methods, rigorously reviewed with minimized biases and has great clinical implications. The strongest evidence based on the evidence hierarchy is systematic reviews, which draws conclusions from many randomized controlled trails (Polit & Beck, 2012).

There are many versions of the hierarchical evidence levels. When deciding on basing clinical interventions on evidence, there are two specific models to look at. They both describe levels of evidence and are depicted as pyramids. The first is the 6S model, with the “more patient-specific” information listed at the top of the pyramid (Houser, 2015). The top of the pyramid has the least amount of information as compared to the base, it is more relevant, but it yields the least amount of information (2015). Conversely, the more abundant information found at the bottom is less relevant to the specific intervention in question (2015). Also, the searches conducted at the more basic levels typically take less time to yield results due to the broader relationship to the intervention in question (2015). The 6S model of hierarchical pyramid of evidence are listed as follows from highest to lowest:

Research and best-practices are an integral part of evidence-based management(EBM) and allow an organization to successfully implement EBM into their facilities. HSHS-EWD is a group of four hospitals that work with several clinics and healthcare providers to promote the health and well-being of many local communities. Connie Dorn, manager of central scheduling and prior authorization, is located within the revenue department and oversees registration and scheduling of the four different hospitals. During her 10-year tenure with the hospital systems she has seen many changes occur that have been beneficial to the hospitals, patients, and staff. Management meets on a continuous business to discuss areas that need improvement in order to stay on top of the latest advancements in the medical community. Connie currently sits on many boards, teams, and groups within the hospital system and is very experienced in the utilization of research and best-practices in regards to EBM. She recently utilized these skills while seating on a team that was trying to find a solution to denial of claims and poor customer satisfaction due to lack of authorization being in place. During the research phase it was discovered that the authorization team was obtaining authorization, however, physician offices were ordering the test incorrectly causing the radiologist to update the orders. Her team eventually found a solution that is in the process of being rolled out system wide called ACR-Select.

Majid,S.Foo,S.Luyt,B.Ahang,X.Theng,YL.Chang,YK.Mokhtar,IA.(2011) Adopting and evidence-based practice in clinical decision making: nurses’ perceptions, knowledge , and barriers. Journal of the Medical Library Association 99(3) PP229-236.

Thinking critically and making decisions are important parts of today’s business environment. It is important to understand how the decision making process works and the steps involved. The nine steps of the decision making process are: identifying the problem, defining criteria, setting goals and objectives, evaluating the effect of the problem, identifying the causes of the problem, framing alternatives, evaluating impacts of the alternatives, making the decision, implementing the decision, and measuring the impacts. (Decision, 2007.) By using various methods and tools to assist in making important business decisions an individual can ensure the decisions they make will be as successful as possible. In this paper it

Many times when faced with a hard decision to make or one that involves many different factors or consequences the executive tends to look for “an educated guess” or “take a calculated risk” but no real calculation is done nor any education is obtained to deal with uncertainty concerning the decision.