Making sound decisions is paramount to effectiveness in nearly any social arena.

For

this reason, judgment and decision making has become a prominent research topic among

psychologists, economists, and organizational scholars. The relationship between placement

in the hierarchy and decision making is particularly important. As individuals move toward

the top of a social hierarchy, there is increasingly more to gain from wise decisions about

how to invest one’s time, money, and effort as well as more to lose from poor choices.

Furthermore, the decisions made by those at the top tend to affect a wider array of people,

which means that their choices carry more weight than those of less prominent members in

the group. Consequently, it is important for behavioral researchers to more fully understand

and illuminate how one’s placement in a social hierarchy shapes judgment and decision

making. In this chapter, we aim to further this goal by examining the following question:

When and why does having a position of elevated power and status relative to others

facilitate versus hinder effective decision making?. hence this assignment will distil the

barriers to individual decision making, evidence based decision making and managing

decision sections dwon to 3 – 5 key bullet points per section.

As a team leader like Tom let as discuss the potential barriers that we should be aware of
during the decision-making processes.

The first to be discussed is individual decision making. There are a number of barriers to
effective decision-making. Effective managers are aware of these potential barriers and try to
overcome them as much as possible.

Bounded Rationality: While we might like to think that we can make completely rational
decisions, this is often unrealistic given the complex issues faced by managers.
Nonrational decision-making is common, especially with nonprogrammed decisions. Since
we haven’t faced a particular situation previously, we don’t always know what questions to
ask or what information to gather. Even when we have gathered all the possible information,
we may not be able to make rational sense of all of it or to accurately forecast or predict the
outcomes of our choice. Bounded rationality is the idea that for complex issues we cannot be

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completely rational because we cannot fully grasp all the possible alternatives, nor can we
understand all the implications of every possible alternative. Our brains have limitations in
terms of the amount of information they can process. Similarly, as was alluded to earlier in
the chapter, even when managers have the cognitive ability to process all the relevant
information, they often must make decisions without first having time to collect all the
relevant data their information is incomplete. Reyna, V. (2004).

Escalation of Commitment: Given the lack of complete information, managers don’t always
make the right decision initially, and it may not be clear that a decision was a bad one until
after some time has passed. For example, consider a manager who had to choose between two
competing software packages that her organization will use on a daily basis to enhance
efficiency. She initially chooses the product that was developed by the larger, more well-
established company, reasoning that they will have greater financial resources to invest in
ensuring that the technology is good. However, after some time it becomes clear that the
competing software package is going to be far superior. While the smaller company’s product
could be integrated into the organization’s existing systems at little additional expense, the
larger company’s product will require a much greater initial investment, as well as substantial
ongoing costs for maintaining it Van der Heide I, van der Noordt M, Proper KI, Schoemaker
C, van den Berg M, Hamberg-van Reenen HH ( 2016). At this point, however, let’s assume
that the manager has already paid for the larger company’s (inferior) software. Will she
abandon the path that she’s on, accept the loss on the money that’s been invested so far, and
switch to the better software? Or will she continue to invest time and money into trying to
make the first product work? Escalation of commitment is the tendency of decision-makers
to remain committed to poor decisions, even when doing so leads to increasingly negative
outcomes. Once we commit to a decision, we may find it difficult to reevaluate that decision
rationally. It can seem easier to “stay the course” than to admit (or to recognize) that a
decision was poor. It’s important to acknowledge that not all decisions are going to be good
ones, in spite of our best efforts. Effective managers recognize that progress down the wrong
path isn’t really progress, and they are willing to reevaluate decisions and change direction
when appropriate. Pfeffer, J. (2010).

Time Constraints: Managers often face time constraints that can make effective decision-
making a challenge. When there is little time available to collect information and to
rationally process it, we are much less likely to make a good nonprogrammed decision. Time
pressures can cause us to rely on heuristics rather than engage in deep processing.

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While heuristics save time, however, they don’t necessarily lead to the best possible solution.
The best managers are constantly assessing the risks associated with acting too quickly
against those associated with not acting quickly enough. Pfeffer, J. (2010).

Uncertainty: In addition, managers frequently make decisions under conditions of uncertainty

they cannot know the outcome of each alternative until they’ve actually chosen that
alternative. Consider, for example, a manager who is trying to decide between one of two
possible marketing campaigns. The first is more conservative but is consistent with what the
organization has done in the past. The second is more modern and edgier, and might bring
much better results . . . or it might be a spectacular failure. The manager making the decision
will ultimately have to choose one campaign and see what happens, without ever knowing
what the results would have been with the alternate campaign. That uncertainty can make it
difficult for some managers to make decisions because committing to one option means
forgoing other options. Gladstein, D. L., & Reilly, N. P. (1985).

Personal Biases: Our decision-making is also limited by our own biases. We tend to be more
comfortable with ideas, concepts, things, and people that are familiar to us or similar to us.
We tend to be less comfortable with that which is unfamiliar, new, and different. One of the
most common biases that we have, as humans, is the tendency to like other people who we
think are similar to us (because we like ourselves) Van der Heide I, van der Noordt M, Proper
KI, Schoemaker C, van den Berg M, Hamberg-van Reenen HH ( 2016).While these
similarities can be observable (based on demographic characteristics such as race, gender,
and age), they can also be a result of shared experiences (such as attending the same
university) or shared interests (such as being in a book club together). This “similar to me”
bias and preference for the familiar can lead to a variety of problems for managers: hiring
less-qualified applicants because they are similar to the manager in some way, paying more
attention to some employees’ opinions and ignoring or discounting others, choosing a
familiar technology over a new one that is superior, sticking with a supplier that is known
over one that has better quality, and so on.It can be incredibly difficult to overcome our
biases because of the way our brains work. The brain excels at organizing information into
categories, and it doesn’t like to expend the effort to re-arrange once the categories are
established. As a result, we tend to pay more attention to information that confirms our
existing beliefs and less attention to information that is contrary to our beliefs, a shortcoming
that is referred to as confirmation bias. In fact, we don’t like our existing beliefs to be
challenged. Such challenges feel like a threat, which tends to push our brains towards

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the reactive system and prevent us from being able to logically process the new information
via the reflective system. It is hard to change people’s minds about something if they are
already confident in their convictions. So, for example, when a manager hires a new
employee who she really likes and is convinced is going to be excellent, she will tend to pay
attention to examples of excellent performance and ignore examples of poor performance (or
attribute those events to things outside the employee’s control). The manager will also tend to
trust that employees and therefore accept their explanations for poor performance without
verifying the truth or accuracy of those statements. The opposite is also true; if we dislike
someone, we will pay attention to their negatives and ignore or discount their positives. We
are less likely to trust them or believe what they say at face value. This is why politics tend to
become very polarized and antagonistic within a two-party system. It can be very difficult to
have accurate perceptions of those we like and those we dislike. The effective manager will
try to evaluate situations from multiple perspectives and gather multiple opinions to offset
this bias when making decisions.

Conflict: Finally, effective decision-making can be difficult because of conflict. Most

individuals dislike conflict and will avoid it when possible. However, the best decision might
be one that is going to involve some conflict. Consider a manager who has a subordinate who
is often late to work, causing others to have to step away from their responsibilities in order
to cover for the late employee. The manager needs to have a conversation with that employee
to correct the behavior, but the employee is not going to like the conversation and may react
in a negative way. Both of them are going to be uncomfortable. The situation is likely to
involve conflict, which most people find stressful. Yet, the correct decision is still to have the
conversation even if (or especially if) the employee otherwise is an asset to the department.

Having looked at barriers to individual decision making, let us now turn our focus to
barriers to evidence-based decision making. The existence and availability of evidence on its
own does not guarantee that the evidence will be demanded and used by decision and policy
makers.

Individuals' capacity to make evidence-based decisions is limited to the extent that

organizations facilitate and support such decisions. In the healthcare context 'organizations'
not only include all of the substructures and subcultures of the local practice environment, but
also the wider professional and social milieu, and prevailing political and financial contexts.

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Barends E, Villanueva J, Rousseau DM, Briner RB, Jepsen DM, Houghton E, Ten Have S.
(2017).

Decision and policy-makers, especially in low-income settings, often confront ethical

dilemmas about determining the best available evidence and its utilization. This dilemma can
be in the form of conflict of evidence, scientific and ethical equipoise and competing
evidence or interests. Consequently, decisions are made based on convenience, personal
preference, donor requirements, and political and social considerations which can result in
wastage of resources and inefficiency. To mitigate these challenges, the use of "Value- and
Evidence-Based Decision Making and Practice" (VEDMAP) framework is proposed. This
framework was developed by Joseph Mfutso-Bengo in 2017 through a desk review. It was
pretested through a scoping study under the Thanzi la Onse (TLO) Project which assessed the
feasibility and acceptability of using the VEDMAP as a priority setting tool for Health
Technology Assessment (HTA) in Malawi. The study used mixed methods whereby it
conducted a desk review to map out and benchmark normative values of different countries in
Africa and HTA; focus group discussion and key informant interviews to map out the actual
(practised) values in Malawi. The results of this review confirmed that the use of VEDMAP
framework was feasible and acceptable and can bring efficiency, traceability, transparency
and integrity in decision- policy making process and implementation. Barends E, Villanueva
J, Rousseau DM, Briner RB, Jepsen DM, Houghton E, Ten Have S. (2017).

Evidence-based practice is multi-disciplinary practice (Muir Gray 1997). However,

multi-disciplinary practice as a concept is difficult to define and measure. A mechanism for
multi-disciplinary care planning (i.e. where all the relevant professional gro_~ups discuss the
management of a particular patient) was not in place in all areas of the trust. From an
operational management perspective, this was explained as being partly due to the
development of wardbased clinical teams being frustrated by the exigencies of an almost
continuous pressure on beds and the fact that in a number of cases 'medical' consultants work
in more than one hospital. However, there was also a professional, cultural dimension as in
some areas it appeared that the historical distinctions between the professions remained
strong.

The last one to be discussed is group decision making section. Values are principles
or standards that reflect the common morality among a group of people that motivates and
guides actions to desirable goals Anderson K, Stowasser D, Freeman C, Scott I. (2014).

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VBDM is an ethical or moral compass that guides the decision‐making process ensuring that
decision making demonstrates the vision of a healthcare system. It also guides the process of
work as well as aids in establishing and maintaining or improving upon the integrity of
organization . In the context of a health system, Riva and Pravettioni (2016) state that values
help a healthcare system look beyond the economics of running the system and consider
making decisions geared towards “adding value to the patient”. Incorporating values in
decision making would ensure that care for the patient encompasses their overall health‐
related quality of life, patient well‐being, and health outcome. Furthermore, VBDM helps to
produce the maximum good, prevent professional misconduct and negligence, manage
conflict of interest and ethical issues and promote moral capital. McCartney (2005) suggested
that VBDM can only be successful if the problem at hand is clearly defined. The values used
should be specific, aligned, appropriate and supported by evidence. The role of values
ensures a clear plan of action, but also serves as a constant reminder of the goals, ensures the
production of the maximum good and the ethical conduct to reflect the organization's goals
are reflected, However, not all values are the same or considered equal, with some values
overriding others. In addition, values are not always supported by evidence, leading to
subjective value selection, resulting in poor decision making thereby wasting time and
resources. Anderson K, Stowasser D, Freeman C, Scott I. (2014)

In conclusion, The extent to which the effects of power on decision making are

moderated by individual level and situational variables in real world organization may allow

individual to provide clearer recommendations about ways in which people can shield

against negative effects of power. Decision making of individuals who have power in work

settings. It is also important to examine whether status and power differ in the extent to which

they influence decisions and whether status moderates the effects of power on decision

making.

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References

Muir Gray J A (1997) Evidence based healthcare: how to make health policy and
management
decisions. Churchill Livingstone, London.

Anderson K, Stowasser D, Freeman C, Scott I. (2014) Prescriber barriers and enablers to

minimising potentially inappropriate medications in adults: a systematic
review and thematic synthesis. BMJ Open.

Swennen MH, van der Heijden GJ, Boeije HR, et al (2013) . Doctors’ perceptions and use of
evidence-based medicine: a systematic review and thematic synthesis of
qualitative studies. Acad Med.

Barends E, Villanueva J, Rousseau DM, Briner RB, Jepsen DM, Houghton E, Ten Have S.
(2017) Managerial attitudes and perceived barriers regarding evidence-based
practice: An international survey. PloS one.

Van der Heide I, van der Noordt M, Proper KI, Schoemaker C, van den Berg M, Hamberg-
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Reenen HH ( 2016). Implementation of a tool to enhance evidence-informed decision
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Policy:
A Journal of Research, Debate and Practice.

Gladstein, D. L., & Reilly, N. P. (1985). Group decision making under threat: The Tycoon

game. Academy of Management Journal, 28(3), 613-627.

Pfeffer, J. (2010). Building Sustainable Organizations: The Human Factor. The Academy of

Management Perspectives, 24(1), 34-45.

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