How to solve decision deadlock with team-based decision making

Content submitted by Thrive Pet Healthcare, a dvm360® Strategic Alliance Partner

The situation

Most of us know it: The team has to make a decision. The issue that requires the decision affects several key stakeholders, perhaps even more than one group in the hospital. No matter how much time and effort team members put in, they cannot make a satisfactory decision.

Inevitably, everyone turns to the “boss” to make the final call. But once made, the decision pleases few. Blame, whether spoken or not, is all too common.

So what’s the problem?

Traditionally, this situation has been analyzed as a problem of leadership, teamwork, or both. The commonly used solution is to strengthen the leader’s team building and communication skills to help build mutual trust within the team. This strategy misses the real problem, which lies in the decision-making process itself. The deadlock is inherent when a group tries to arrive at a collective preference based on all individual preferences.

There are practical measures to break the impasse. These actions allow teams to break the blame cycle and move toward flawless decision-making.

Break the cycle and conquer the impossible

Let’s see how this can be implemented using a real example from the trenches:

Confirm the issue

Treatments for inpatients are sometimes delayed, missed, or go slightly differently than the treating veterinarian intended. The team comment that this is because everyone is very busy and finding it difficult to understand the very old, somewhat outdated inpatient treatment sheets currently hanging on each cage. Everyone believes that a new system is needed.

Clearly articulate what outcome you are seeking and achieve alignment with the desired outcome

It is important to separate the discussion of the desired outcome from the discussion of how to achieve it. In this example, the team is aligned that all treatments should be delivered to each patient in a timely and accurate manner, using a system that is efficient for caregivers.

Ask team members to provide their proposed solution(s) to achieve results

Each key stakeholder on the team should be encouraged to submit their idea(s) to achieve the goal that the team is aligned towards. Some team members would like a new treatment sheet to be attached to the cage with more ergonomic formatting. Some want to switch to an electronic paperless treatment sheet. At the same time, some want to use a dry-erase board to note which patients are treated each hour to draw attention to those cages. The possibilities are plentiful and varied.

State the pros and cons of each option and develop new options that retain the best qualities of the existing ones.

Bring up preferences early and determine if those preferences are flexible. These strategies reduce the likelihood of a stalemate.

The team discusses each option presented and records identified pros, calls, and resources required to implement each option. Team members also indicate their ranking of options and name any immovable barriers, called walls, to the implementation of options. Walls cannot be moved, but fences can.

In this discussion, the option calling for a fully electronic iPad-based treatment system was rejected because the hospital budget would not be able to afford it this year. A fence barrier was identified for some technicians to the ability to move to a new hanging treatment sheet with a simultaneous whiteboard for use in the central intensive care unit. These technicians said they wouldn’t advocate having to check two different locations — the hanging treatment towels and the white board — but would be willing to consider the perceived redundancy if the team felt it was the most likely would be to achieve a matched result that is 100% guaranteed. accurate and timely treatments for all patients at all times.

Be prepared to make the final decision as the 51% stakeholder

There is no real committee decision. In most cases, someone has to be the person who makes the last call. This person, usually the team leader, boss or manager, should be identified at the beginning of the decision-making process. When the above steps are complete, the 51 percent stakeholder makes the final decision.

In our example, the team was fairly evenly split between a newly designed treatment sheet on the cage side and the simultaneous use of that sheet plus a white board in the central ICU to note which patients were being treated hourly. The team leader chose the latter solution, sharing with the team the belief that this option would best achieve the team’s desired outcome without undue workflow inefficiency.

Circle back to see how things are working for the team and iterate as needed

Make sure the team knows what the exact plan will be to achieve this at the time the decision is made. In this example, our team leader advised the team that their individual feedback on the success of the new system would be sought through several different mechanisms.

After a month of using the new system, a survey was sent out to all team members to get feedback. At this point, the number and percentage of late, missed and inaccurate treatments would also be calculated and compared to these numbers using the old system. Finally, there would be an open-door policy for feedback from any team member, anytime in person, orally, or via email.

The Ground Rules

Ground rules are essential to create safety and a sense of “terra firma” for the team.

It is important that there is no triangulation or side-talk during the decision-making process. Discussions for decision-making should be transparent and direct. It is also important that decision making considerations take place over a reasonable time frame; Decision-making should not be rushed, but an achievable timeframe should be set to complete the deliberations and act on the decision.

Make sure the team knows each decision is followed up with iterations as needed. Establish defined points in time when a new process implemented as a result of a team decision will be evaluated to assess effectiveness, efficiency and accuracy. Don’t be afraid to revisit and reevaluate the decision if it doesn’t go as planned. Team-based decision making is not about whose idea was right; it is about which decision achieves the desired result most completely and with ease.

The final result

A team cannot make effective decisions if its members do not trust or listen to each other. Open, transparent communication and the implementation of the declared measures are also of crucial importance. With these tips, you can guide your team to make effective, nonjudgmental decisions to improve team culture, morale, and commitment to the benefit of your patients and pet owners.

Continue reading

Fresh B. When teams can’t make up their minds. Harvard Business Review. November 2008. Accessed September 7, 2022. https://hbr.org/2008/11/when-teams-cant-decide