Good or Bad Decisions Need Not Be Ugly

Why Good Leaders Make Bad Decisions is a reminder of the unintended biases we face as we set operational and strategic direction for complex organizations. In this article from the February, 2009 Harvard Business Review the authors, Andrew Campbell, Jo Whitehead, from the Ashridge Strategic Management Centre in London and Sydney Finkelstein of Dartmouth's Tuck Business School, remind us how easily (and why) our brains can "...leap to conclusions and are reluctant to consider alternatives..." resulting in flawed decisions.

The authors of this article use examples and explications of business and government leadership decision making, good and bad, to examine two vulnerabilities humans face in examining situations - known by their neuro-scientific terminology as pattern recognition and emotional tagging. Pattern recognition refers to the 'hard wired" brain process, such as are commonly relied upon by chess masters playing multiple opponents, that permits humans to efficiently make current situation decisions based on an integration of information and outcome patterns experienced previously.

By overly relying on recognition of patterns consistent with his knowledge that early crisis information tends to be inaccurate, Matthew Broderick (Chief of the Homeland Security Operations Center early in the Hurricane Katrina debacle) initially underestimated the severity of that storm. As we know, that flawed decision had disastrous consequences. Similarly, the authors recall the fateful decision made by An Wang, founder of Wang Laboratories which was an early leader in the word processing industry, to maintain a proprietary operating system for his computers rather than develop word processing applications for the emerging IBM standard computers. The result of this decision, based largely on Wang's emotional, rather than logical aversion to IBM , ultimately led to the company's collapse. Were these just "bad judgment" or did they result from reliance on known patterns of flawed decision making that can be averted or attenuated? The authors claim the latter and offer specific guidance to avoid it.

Obviously clinical and administrative health care leaders face strategic, operational, and crisis situations requiring them to make decisions that may impact the health and sometimes the lives of individuals and health care organizations. Despite the stakes, they must rise to the challenge of decision making - it's what leaders do best. And what they are chosen and relied upon to do. But how do they protect ourselves from misusing important tools at their disposal - the recognition of solutions patterned on prior solutions or the emotional "gut instinct" that has previously served them well? Campbell, Whitehead, and Finkelstein recommend seven specific steps or techniques (health care) leaders can use to minimize the risk of poor decisions due to unrecognized bias. These include intentionally considering an array of options (rather than one or two); examining (and balancing) the agendas, expertise, and self-interest of the decision influencers; examine institutional and personal memory that might be influencing the decision to be sure it is accurate and relevant; and reviewing the decision making process and pitfalls again before finalizing and acting. The difference between making good and bad decisions may be steps that minimize the potential for an overly narrow, and thus ugly, process.