Common Sense is Not Common. So How Can A Leader Make Good Decisions?

In education today there is a move away from top-down leadership toward a more inclusive, shared or participative leadership model. This model includes shared decision-making, which has the potential to empower and radically change any organization willing to take the risk of implementing this type of leadership. This article combines another important aspect of leadership to the concept of shared decision-making: servant leadership. With a servant-leader at the helm and shared decision-making in place, a school has the potential to grow in sync with the needs and desires of its stakeholders

Shared decision making between registrars and patients : web based decision aids

BACKGROUND: Current evidence suggests that doctors do not always involve patients in decisions; this may be due to lack of training. This study explores the feasibility of using web based decision aids (DAs) to improve the skills of general practice registrars in sharing decisions with patients. METHOD: Interviews were conducted with registrars to explore their attitudes to shared decision making. Following an educational intervention, registrars were asked to adopt shared decision making within their consultations using DAs as appropriate. The registrars were interviewed again to explore their experiences and any barriers to the process. RESULTS: Registrars had positive views about the shared decision making process but required more training. They had mixed opinions about the use of DAs and identified several barriers to their use. They felt that they had learned from the project and process without necessarily wanting to pursue the use of DAs as interactive tools, preferring to use them as educational resources

What lies beneath? The role of informal and hidden networks in the management of crises

Crisis management research traditionally focuses on the role of formal communication networks in the escalation and management of organisational crises. Here, we consider instead informal and unobservable networks. The paper explores how hidden informal exchanges can impact upon organisational decision-making and performance, particularly around inter-agency working, as knowledge distributed across organisations and shared between organisations is often shared through informal means and not captured effectively through the formal decision-making processes. Early warnings and weak signals about potential risks and crises are therefore often missed. We consider the implications of these dynamics in terms of crisis avoidance and crisis management

Strengthening group decision making within shared governance: a case study

Shared governance is an approach to empowering nurses and other health care workers to have authority for decisions concerning their practice. Commonly, visible definers of shared governance are groups of workers known as ‘councils’ whose membership works collectively to realise a shared goal. The literature is replete with rhetoric as to the benefits of shared governance yet the evidence base concerning shared governance and especially decision-making within shared governance is scant. This paper presents a case study of group decision-making within a UK shared governance council model. The evidence which informs the case study is drawn from a doctoral action-research study to strengthen decision-making within the model. Eight key factors affecting decision-making and four supportive conditions are presented and incorporated into a conceptual model. Within the case study, presence of these factors was found to be necessary but not sufficient to enhance decision-making. Factors included having a clear issue, clear aim, fitting issue, manageable issue, size, lead person allocated, level of authority, background information, key informant/s, a mechanism for evaluation, adequately skilled members, support/guidance and sufficient/appropriate membership. Aspects of group decision-making processes are highlighted and compared with established management, shared governance and group dynamics theory

Shared Care, Elder and Family Member Skills Used to Manage Burden

Aim. The aim of this paper is to further develop the construct of Shared Care by comparing and contrasting it to related research, and to show how the construct can be used to guide research and practice. Background. While researchers have identified negative outcomes for family caregivers caused by providing care, less is known about positive aspects of family care for both members of a family dyad. Understanding family care relationships is important to nurses because family participation in the care of chronically ill elders is necessary to achieve optimal outcomes from nursing interventions. A previous naturalistic inquiry identified a new construct, Shared Care, which was used to describe a family care interaction that contributed to positive care outcomes. Methods. A literature review was carried out using the databases Medline, CINAHL, and Psych-info and the keywords home care, care receiver, disability, family, communication, decision-making and reciprocity. The results of the review were integrated to suggest how Shared Care could be used to study care difficulties and guide interventions. Results. The literature confirmed the importance of dyad relationships in family care. Shared Care extended previous conceptualizations of family care by capturing three critical components: communication, decision-making, and reciprocity. Shared Care provides a structure to expand the conceptualization of family care to include both members of a care dyad and account for positive and negative aspects of care. Conclusions. The extended view provided by the construct of Shared Care offers practitioners and scholars tools to use in the context of our ageing population to improve the effectiveness of family care relationships

Modeling the University Decision Process: The Effects of Faculty Participation in University Decision Making

This paper develops models of decision making in a university setting with and without faculty participation. The models predict values for the level of services or programs offered and the quality of those services in a university setting for either private nonprofit or public universities. These predictions indicate conditions under which outcomes are similar or differ with faculty participation in the decision process. The model predicts that without shared governance that universities may overinvest in non-academic quality (e.g. athletics, recreational activities). This would be exacerbated in for-profit forms of higher education. Notably, nonprofit and/or public institutions are not inefficient relative to for-profit institutions, which questions the rationale for subsidies to for-profit institutions. If academic quality provides positive externalities as has been suggested in the literature, then shared governance may be socially preferred to university decision making without faculty involvement.higher education, faculty governance, university decision making, incentives, nonprofit organization, public organization, organizational behavior

Trends and Regional Variation in Hip, Knee and Shoulder Replacement

Analyzes patterns in underuse or overuse of joint replacements among Medicare beneficiaries by geographic regions and race/ethnicity. Explores underlying factors and highlights the need for physician and patient education and shared decision making

Shared Care Contributions to Self-Care and Quality of Life in Chronic Cardiac Patients

Shared care is an interpersonal interaction system composed of communication, decision making, and reciprocity; it is used by patients and family caregivers (care dyads) to exchange social support. This study’s purpose was to describe the contributions of shared care to outcomes for individuals with cardiac disease. A secondary data analysis was used to answer the following questions. What is the association between elements of shared care and patient outcomes? Do dyad perceptions of shared care differentially contribute to patient outcomes? Participants in this study were 93 individuals with a cardiac disease and 93 family caregivers. Composite index structured equation modeling was the analytic tool. Caregiver communication and reciprocity were related to patient mental quality of life. Patient communication and reciprocity were related to their own mental and physical quality of life and self-care confidence. Findings from this study contribute a better understanding of how care dyads are integral to patient outcomes