Theories to Ponder Upon

Management as Decision Making

(Herbert Simon)
hospital institution is a network of decision
makers
*Other Decision Making
3 steps process:
strategy:
*2 approaches to decision 1. Listing alternative
1. Maximax best maximum
making strategies for
gain is better than resolvitrng
the best the
a. Optimizing search for the
gain
best alternative possible problem
- used by2. Opportunistic Strategy
economic man 2. Determine the
- decision is based on
consequence that
- whats best evidence would follow each
b. Satisfying3. Minimax
using the/ Strategyalternative
of mini-
first workableregret
solution - Minimizing the
3. Comparative
maximum
- used by administrative regret/ possible
man evaluation of
- whats enoughloss. consequences
CHANGING PEOPLES BEHAVIOR
 LADDER
INFERENCE
(Chris Argyris
1923)

study on the
patterns of
reasoning that
explains ones
behaviour
 LADDER INFERENCE
the step-by-step Tip 1:
Use the Ladder of Inference at any of stage of your thinking
process. If you're asking any of the following questions,

reasoning process the model may prove a useful aid:

Is this the "right"

helps you remain conclusion?
objective and, Why am I making
when working or these assumptions?
challenging Why do I think this is
others, reach a the "right" thing to do?
shared conclusion Is this really based on
all the facts?
without conflict.
Why does he believe
that?
 Use the following steps to challenge
thinking using the Ladder of Inference:
2. Identify where on the ladder you are. Are you:

Selecting your
data or reality?
1. Stop! It's time Interpreting what
to consider it means?
your reasoning. Making or testing
assumptions?
Forming or testing
conclusions?
Deciding what to
do and why?
 Use the following steps to challenge
thinking using the Ladder of Inference:
3. From your
current
"rung,"analyz
e your
reasoning by 4. With a new sense of reasoning (and perhaps a
wider field of data and more considered

working back assumptions), you can now work forwards again

step-by-step up the rungs of the ladder.

down the
ladder. This
will help you
trace the facts
Case Study
The Nursing Service Director
has just read the latest
performance of the ICU. The
incidence of infection in
Supervisor Edens area are very
high again for two months in
a row. It's simply not good
enough. She needs to be fired!
 So let's see how the scenario plays
using the Ladder of Inference
The latest month's infection statistics (reality)
have come in, and the Nursing Service Director
immediately focuses on Edens ICU (selected
reality). Incidence of infection are increasing
again (interpreted reality). The Nursing Service
Director assumes that the high incidence of
infection is entirely to do with the Edens
performance (assumption), and decides that
Eden hasn't been performing well (conclusion).
So he forms the opinion that Eden isn't up to
the job (belief). He feels that firing Don is the
best options (action).
 Now let's challenge the Sales Manager's thinking using the
Ladder of Inference:

The NSD came to the statistical report with an existing belief

that Eden, a new supervisor, couldn't possibly be as good as
the "old-timers" who he has trained for years. He focused on
Eden's territory because Eden is the newest supervisor, and
selected facts that supported what he already believed (that
Eden wouldn't be doing a good job).
Although the infection incidence are up in Eden's area, they
have actually dipped less than in other areas. Eden is actually
a doing good as a supervisor, but he and his colleagues have
in fact been let down by old equipments, rusted instruments
and short and delayed supply of disinfectants, and gloves are
running out of stock.
Once the NSD changes his assumptions, he will see the need
to focus on solving the supply and equipment issues. He can
also learn from Eden how is it that Eden has performed
better than other supervisor in the face of equipment and