Navigating in a New Moon: Utilizing an Objective Decision-Making Framework in Uncertain Times

Updated on March 11, 2011

Whether navigating the seas or migrating across an unknown landscape, the ability to analyze available information, understand potential advantages and consequences, and craft a plan for optimizing benefit while mitigating risk has been the differentiator between success and failure since the days of antiquity.

This formula remains applicable for today’s organizations, especially in the current regulatory environment. Recent passage of the Patient Protection and Affordable Care Act (PPAC), enforcement of some revised and supplemented provisions of the Health Insurance Portability and Accountability Act (HIPAA) through the Healthcare Information Technology for Economic and Clinical Health Act (HITECH), and pending financial reform legislation has prompted many organizations within the healthcare and financial services value chains to consider the effects of this legislation on their current operations and ability to attain future objectives.

With many of the provisions outlined in the legislation awaiting additional clarification, these firms must prepare themselves to compete in an unknown business landscape. This, coupled with the volatile (at best) nature of the current economic climate, has found small business owners and corporate executives alike clamoring for clarity as to what the future may hold.

In too many cases, the haze placed over an organization’s future through these uncontrollable environmental risk factors has resulted in a moratorium on strategic decision making or forced the hand of organizations to invest millions in software products or services with the only objective being future “compliance”. These solutions often fail to consider how the investment will help the organization to achieve its vision and provide additional value to its shareholders, funders, customers, or the individuals it was created to serve.

However, as with all things, a silver lining exists. Organizations possessing a strong decision-making framework can develop a competitive advantage by continuing to make strategic improvements that will not only align with regulatory requirements, but will prepare the organization for greater operational efficiencies while others, who continue to wait, later scramble to comply. This framework consists of five key tenants:

  1. Understanding the Business Environment
  2. Articulating the Objective
  3. Determining Decision Alternatives
  4. Developing an Implementation Plan
  5. Preparing for Change

Get Your Bearings: Defining the Business Environment

When detailed maps did not exist, sailors worked to keep their bearings by staying within sight of land, understanding the characteristics of winds and currents, and using celestial navigation. Much like ancient seafarers, an organization must too get its bearings by defining the environmental landscape in which it operates. While most organizations possess an understanding of the current landscape, the increased uncertainty in defining the future provides a difficult challenge. Before charting a course, decision makers within organizations should begin by reviewing information that currently is available around them to better understand what may lie ahead.

With the current speed and ease of distributing information, many firms and governmental agencies have compiled key points from recent legislation and provide interpretation on how these new provisions will be implemented; However, nothing can replace the value gained from reading the legislation’s original language. It will not only provide you with a thorough understanding of what has been released, but a better understanding of what is yet to come. The information gleaned from these documents provides an initial map of the regulatory landscape and often a timetable for when additional clarity will be provided.

Once the external environment has been defined, organizations can then look internally to determine current capabilities (areas of strength and weakness) that may allow it to become compliant with applicable regulations and/or to capitalize on opportunities afforded within this newly defined environment. Fortunately, much of the legislation recommends or requires an organization to conduct some form of internal assessment to determine the necessary level of compliance (as in the HIPAA/HITECH Act Risk Assessment). These assessments should look beyond the requirements for compliance and assess the culture, resources, and supplier/consumer relationships. Knowledge in these areas will become crucial in making the most appropriate decision for your organization.

Develop Your Charter: Articulating the Objective

An understanding of the potential business climate and internal capabilities provides only part of the picture. An organization must also ensure that strategic decisions align with the role they wish to fulfill in this new business environment. Any goal or objective should consider the organization’s purpose (mission), what it wishes to become (vision), and its responsibilities to internal and external stakeholders (values).

This determination should not be made within a vacuum but completed through the solicitation of feedback from key stakeholders that are integral to the successful implementation of the strategic decision. Obtaining this feedback not only aids in the collection of multiple perspectives, but also lays the foundation for gaining acceptance among key stakeholders when the organization begins implementing the plan.

Determine Your Options: Defining Decision Alternatives

Before embarking on any voyage, literal or figurative, determining the route to take often begins with an analysis of potential options. In defining these options, various internal and external factors should be considered. As in the golden age of seafaring when weather conditions, crew experience, and piracy were necessary considerations in choosing a course, modern day organizations should follow a similar process by defining the potential options available toward achieving any organizational objective, especially given the regulatory and economic environment as well as the organization’s internal capacity. It is important to note that these alternatives should be mutually exclusive, completely exhaustive, and may vary only in the size, scale, or timeline for implementation.

Chart Your Course: Develop an Implementation Plan

Once all decision alternatives have been defined, identify the criteria for evaluating each alternative in an objective manner. These criteria often cluster around the areas of economic feasibility (i.e. cost and ROI), administrative operability (i.e. internal capacity to implement), political palatability (i.e. how the decision would be received by key internal and external stakeholders), and alignment with the objectives of the organization (i.e. mission, vision, and values). In decisions that remain highly reliant upon future state assumptions about the organization, industry, or larger economic climate, additional criteria should be included to capture the degree with which the decision depends on these assumptions, both in ability to implement the decision and its perceived value.

It is critically important to complete this alternative evaluation in an objective and well-documented manner. This will allow for the presentation of decision-making logic to supervisors, peers, and subordinates as well as other applicable stakeholders to evidence the process performed, support the decision, and obtain acceptance.

Remain Alert: Understand and Prepare for Change

After a route has been defined, no ship leaves port without the appropriate navigation equipment. These devices, whether advanced or archaic, are used to ensure alignment with the predefined plan and allow for alteration of the course, as environmental and other factors require. The path defined from even the most thorough execution of a decision-making process is bound to require modification during implementation. This requirement is only exacerbated as the time horizon of the decision is extended. Navigating across a strait where you are able to see the destination generally requires far less modification to the originally charted course than crossing the Atlantic for the first time.

However, even in most controlled environments, a gap will always exist between the planned and the realized. Therefore, outputs from this process should not be viewed as concrete, but rather an initial path that will serve as a compass for navigating the future business climate. Organizations should remain vigilant in reviewing and assessing changes to both the internal and external environment, measuring progress, and reevaluating decision criteria in light of new data as implementation progresses. This will provide senior leadership with the information necessary to make informed decisions about if and/or how to alter the current trajectory in order to maximize their efforts and remain focused on the objective they seek to accomplish.

Scoping Decision Making

The level of time and resources utilized to complete this process can, and should, vary greatly depending on the type of decision being made and level of knowledge held by those making the decision in the applicable areas. This process, if executed efficiently and effectively, should not result in “analysis paralysis”, but clearly display the most appropriate alternative for your organization. The process should provide comfort to all involved that the tools and processes are available to alter the decision, if necessary, as the environment becomes clearer. However, even if this process consists of only yourself, a few hours, and the back of an envelope, the ability to deliberately define the external environment, your internal capabilities, targeted objectives, decision alternatives, and evaluation criteria will provide increased clarity to decisions that otherwise would seem like navigating the Titanic through a sea of icebergs during a new moon.

For more information, visit

+ posts

Throughout the year, our writers feature fresh, in-depth, and relevant information for our audience of 40,000+ healthcare leaders and professionals. As a healthcare business publication, we cover and cherish our relationship with the entire health care industry including administrators, nurses, physicians, physical therapists, pharmacists, and more. We cover a broad spectrum from hospitals to medical offices to outpatient services to eye surgery centers to university settings. We focus on rehabilitation, nursing homes, home care, hospice as well as men’s health, women’s heath, and pediatrics.