Leadership Transformation Series 

Decision Making Traps: Decider Beware

This is Part 4A in this Four-part Leadership Transformation Series (LTS); 4B will follow.

Transformation in healthcare is personal: it requires the transformation of health system leaders. The LTS begins to speak to key differences in some of the fundamentals of transformational vs traditional leadership in healthcare.

 This article focuses on how we make decisions: 4A Reviews decision-making errors.

4B Addresses how to mitigate decision-making errors

 4A Healthcare Transformation and Decision-making Errors

Leaders – and their organizations - succeed or fail based on their decisions. Yet the evidence is clear that our decision making is perilously fraught with biases and irrational behaviors of which we are not even aware. These biases are so ingrained in our psyche that, like water to fish, we cannot imagine that they are even there, much less clouding our view – regardless of how “well-intended and objective” we believe we are. In short, bad decision-making is largely hard-wired.’ Just as many medical errors are associated with unexplained variation in medical decision-making (How Doctors Think), so too are many leadership errors are associated with unexplained variation in management decision making.  

Traditional change is oriented in the past; it involves more, faster, better, but not different (Daniel Prosser). Transformation is future-oriented; it requires the creation of something from nothing, i.e., letting go and giving up something in the past to create something new. This means that, to do transformation well, it is even more important that our hidden decision biases be flushed out and made explicit. Leaders on a transformation journey are at higher risk for decision making traps and consequences than in traditional change. Said differently, leadership decision making in transformation is less forgiving. 

A brief review of categories and types of decision and judgement errors include the following: