Challenges of Making Decisions Within a Team Environment
Title: Team Decision-making for healthcare leaders within team environments
In decision-making, a team environment involves a group of individuals who possess complementary skills and are committed to common performance goals, purpose, and approach in which they hold themselves mutually accountable. While individual decision-making in health care involves making up of an individual’s mind, group or team decision-making involves the team coming up with the alternative as denoted by Lewin and White (2013). As team members listen to each other, ask and formulate questions, while presenting their positions or arguments, it concerning that teams can make better decisions than single persons. However, the team decision-making is also criticized for the groupthink mentality (Quigley, 2014). This paper presents an evaluation of some of the challenges healthcare leaders face in making decisions within the team environments. The paper as well looks into the difference between team-centered leadership and the leader-centered approaches of decision-making within the healthcare environment. It then discusses possible recommendations that such leaders can adopt in addressing the identified challenges.
The word groupthink is denoted as to have been coined by Irving Janis, a social psychologist in 1972 according to Katopol (2015). It occurs when a group of people end up making faulty decisions since the group pressures lead to the deterioration of reality testing, moral judgment, and mental efficiency. Such teams are often ignoring vital alternatives as they tend to take irrational actions hence dehumanising decision-making. Janis (1982) denotes that a group is often subjected t groupthink when it is made up of members from similar backgrounds, when the members are insulated from external opinions, and when there are no clear objectives and goals for the decision-making process. According to Janis, some of the challenges of the groupthink mentality in decision-making are;
- Self-appointed mind guards where the members protect the leader and the group from any information that is contradictory to the view, decisions, and cohesiveness of the group.
- Unanimity illusion where the majority of the team views and judgments are taken to be very unanimous and not worth being adopted.
- Collective rationalization where the participants discount warnings without having a thorough evaluation and consideration of their assumptions
- Belief in morality inherent where the team ignores the moral and ethical consequences of their decisions since they strictly believe in the rightness of their views
- Direct pressure where the team members are pressured not to express any contrary opinion or argument on any views of the group
- Self-censorship where the team possess deviations and doubts from the perceived consensus of the group.
In health care, leadership is charged with the responsibility of proper decision-making since it is a very sensitive environment dealing with serious health matters and any simple mistake can be very detrimental to the health of an individual as well as the organization. As a result, Quigley (2014) denote that health care leaders are often encouraged to embrace teamwork in making decisions so as to encourage sharing opinions from other relevant professionals. However, groupthink mentality tends to dominate in every team decision-making, the health care leadership included. Additionally, Boin and Nieuwenburg (2013) denote that team decision-making is a key part of health care management. A group of people with experience in different facets of healthcare can help in arriving at vital solutions than an individual could do. However, group settings often result in several potential challenges that need to be addressed beforehand so as to ensure effective team leadership and decision-making. Understanding these situations can hopefully help a leader to avoid dysfunctional group situations or making incorrect choices. In his study, Pandit (2016) denotes that some of the challenges leaders face in making decisions within a team environment include;
In many cases, 80% of the participation in any teamwork is often done by 20% of the group members. In other words, even if the team of decision makers consists of ten brightest and best employees with a range of expertise and skills, the decisions make will only be a contribution of two dominant people. In support of this fact, Lizelle (2015) denotes that in both dysfunctional and extraordinary groups, different roles and dynamics emerge that there are overachieving control freaks in every group which take up every responsibility. The freaks often think that others are either incompetent or minimalists who will only do what is assigned and nothing more while the credit of the work is happily shared by other slackers who sit back to let everyone else do all the work. In such situations, health care leaders end up having solutions and choices that are only discussed or evaluated by part of the team while others wait of taking credit for the results of the decisions made.
Uneven Participation by the Team
For effective health care decisions making, there is a need for early definition efforts from the leader in opening the team discussion process. Most of the team do not adequately characterize or frame the problems and the decision situations while expanding different thoughts in the attempt for identifying a robust set of possible solutions than create the need for gathering information (Beshears & Gino, 2015). At this stage of the process before evaluating the alternative, conformity can be very defective as pointed out by Kelman, Sanders and Pandit (2017). The assumption can hence hurt the leadership performance in decision making especially in the extremes of critical health decisions when the leader put blinders and assume that the crowd will always be right.
In the process, team decision-making often possesses at reality testing suppression, sensor doubts, ignore external information, and confidence in addition to the emerging invulnerability attitude. These factors lead to a closed, out-of-reach, and insular reality of achieving successful decision-making in a team environment for healthcare leaders. In his study, White (2010) denotes that in most cases, some of the team members often portray a convinced idea that their strategy is the only possible and positive way forward. For instance, the leadership can spend a long time defining some goals and health care strategies in a collective leadership reference as they work out ways of achieving the goals of the health care strategies. While the plans may appear very elegant, Akdere (2011) denotes that team members tend to construct on the external influences hence opening way for more fiction as a fact thus guaranteeing failure. After a long time and resources have been spent in strategizing and framing the health plan and goals, escalation of commitment arises thus preventing the team from recognizing the essentiality of starting or sticking to the original objectives of the teamwork in decision-making.
A strong pressure on the leaders as well as the team members as a result of a stiff organizational culture and structure often imposes rigid boundaries as well as strong penalties in case of any negative results or failure of the decisions made. Such a team will feel pressured and isolated resulting to them defining their external and internal freedom of sharing their viewpoints as a survival strategy to avoid blames and the imposed penalties in the case of failure. In such a case, Bennis and Nanus (2011) denote that achieving consensus is the only way to reach to a proper decision-making. However, it blocks out the will of freedom of expression from the members.
In decision-making, leadership can be divided into leader-centered and team-centered leadership. Both types of approaches have a mission, vision, or goals that they strive to achieve by providing direction, motivating the followers, and implementing plans but differ in how they approach their strategies. Leader-centered styles mainly focus on the self-projection and self-realization of the leader. It is common in organizations that depend on authority, strict deadlines, and specific directions. Ballard et al. (2017) denote that the approach is adopted in organizations that have hierarchical or top-down structure. Leader-centered approaches function depending on the vision of the leader as the employees are expected to work in line with the vision of the leader. Leader-centered styles are charismatic, authoritarian, and transactional leadership.
Mismatch with the Organizational Objectives When in Making Decisions
On the other hand, team-centered approaches achieve the organizational success through the growth, realization, and development of the team members. The approach is often adopted in organizations that value the employees or the team members as the most valuable assets of the organization by investing resources for their development. Such organizations often have a flat structure where the team members and the leaders are treated equally as denoted by Lewin and White (2013). The approach gives the employees a voice and a chance to impact the decision-making process of the organization. Team-centered leadership styles include transformational, servant, and participative leadership styles.
Despite the possible challenges that can be experienced in making decisions within the health care system, alignment or conformity can be adopted in promoting or accelerating the process of making decisions and executing the selected solutions. In his study, Wayne (2016) denotes that a leader should ensure that the members supporting the unselected alternatives do not make individual decisions in pursuit of the strategies selected as solutions for the identified challenges. Making a decision in the health care system after an evaluation based on the final results of the outcome after including execution can prove conformity beneficial. In other words, it is vital that a decision is evaluated depending on the process effectiveness as well as the relevant information backing up the decision at the point of team discussion. In the process, Hart (2015) denotes that accountability for the choice needs to be limited to the conformity or alignment to the objectives of the discussion as the decision makers will only find a solution depending on the presented information and the guidance of the leadership. The pressure of holding them accountable in the event of failed execution as well as the unknowable future events to the extent that they are held responsible for the actual process of implementing the decision. The leader can hence ensure conformity in decision-making by adopting the following strategies;
- Strategizing a structured process of decision-making that when regularly used, will assist in preventing the shortcuts that can arise from the groupthink effects since decisions in health care are very crucial.
- The leader can as well create a decision team among the members with a broad diversity and facet of thoughts.
- The leader can increase personal accountability for the participants so as to counter every motivation towards conformity
- The leader can as well source an external expert in the specific area of health care in discussion who will have no motivation on conformity
- The health care organization can as well encourage and train leaders on initial leadership choice on relevant collaboration levels suitable for the decisions being adopted by the team
In his study, Akdere (2011) denotes that the first step of effective decision-making in a team is analysing the present situation so as to comprehend the challenges being experienced completely. The final result will hence best fit the health care when the group begins to work on a decision-making strategy after understanding their goals. For example, a leader can effectively find solutions of expanding a cure of a particular disease to a certain population only after first determining the cause of the infection and the demographics behind the infection. Mindtool (2011) also points out that the process can only be effective when the leader provides the correct information about the scenario of discussion that is time relevant and factually correct. Attempting to arrive at an effective decision will incorrect, or too little information is likely to result in error after costing the health care organization time and resources.
In pursuing irrational consensus, it is advisable that the leader helps the team in evaluating all the potential choices. The step will prevent any hasty decisions as the group will be able to first examine all the negative and positive aspects of other choices hence preventing overlooking the possibility of arriving at the best decision Hart (2015). Choices and different ideas from the team members should be examined or evaluated before the final choice of making a decision. Also, the leader should as well assist the team in understanding and interpreting all the available data and information that will otherwise cause a misunderstanding and poor decision-making in case of a misunderstanding.
Irrational Consensus Pursuit Above Other Views or Priorities
In their study, Bennis and Nanus (2011) denote that teams often make effective decisions by adopting different techniques of solving problems. The leader should hence ensure that the process of decision making in a team environment largely rests on selecting a course of action that follows the evaluation of more than one alternative. To effectively navigate the path of cubing the possible leadership challenges in team decision-making, Kazley and White (2010) denotes that following step-by-step approach;
- Recognizing that a problem exist and there is a need for solutions that can ensure the process progresses positively
- Define the challenge through mapping while evaluating any assumption made to ensure the team fully understands the real issue.
- Gather information- the team need to collect relevant information in relation to the problem identified so as to ensure it was verified correctly and develop alternative solutions
- Brainstorm with the group while asking questions and exploring possible options and selecting the best alternatives.
In the process of evaluating the best alternatives, the leader should ensure active listening, support, and full participation as the members present different views before implementing the best alternative of decision making according to Akdere (2011). The same study denotes that the leader should be aware of the consequences of the decisions made and seek alternative viewpoints that will stick to the health care goals of the organization. In team discussion and decision making, Pandit (2016) denotes that it is essential for a leader to evaluate both sides of the decision-making so as to evaluate their incentives with a positive mind that they are not perfect and can at times make mistakes. Lewin and White (2013) also denote that it is vital for a leader to invite a series of external perspectives at different stages of the team decision-making process and find relevant ways of incorporating such ideas where necessary to ensure better health care. In the process, the leader should lengthen the phase of discussion and focus on the vetting issues while encouraging non-typical process of discussion to improve the quality of discussion. Dealing with a small team with well-defined goals is as well effective and can lead to successful decision-making. A small team often develops the desire of collective responsibility and overcome the dependence on their leader. Synergy and insight are often developed with respect for each other as they each give their opinion or contribution towards the decision-making process.
Conclusion
Teams are often effective in finding solutions to problems as the members are composed of individuals with complementary skills and qualifications. The complementary skills will assist the team members in examining issues from different angles while evaluating the implications of their decisions from different perspectives. Decision-making is hence a tough process that grows in complexity especially when there are groups involved. It is hence necessary not to naively assume that the team of smart people may be immune to the possible several missteps and pitfalls that dots the path of making relevant decisions within the healthcare leadership. Like a common cold, groupthink may not be having a necessary proven cure but have preventive measures that can be adopted so as to prevent it from affecting effective leadership decision-making process in a team environment. Leaders should as well understand their personal leadership styles and strengths in leading teams so as to achieve effective decision-making. It as well opens the mind of a leader to have a broader understanding of their strength and weaknesses as well as the organizational opportunities and threats.
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