scholarly journals Use of Modeling to Inform Decision-Making During the COVID-19 Pandemic: A Qualitative Study

2021 ◽  
Author(s):  
Karl Johnson ◽  
Caitlin Biddell ◽  
Kristen Hassmiller Lich ◽  
Julie Swann ◽  
Paul Delamater ◽  
...  
Keyword(s):  
Decision Making ◽  
Local Level ◽  
Decision Makers ◽  
Disease Spread ◽  
Quality Of Data ◽  
Scarce Resources ◽  
Health Related ◽  
Decision Support Models ◽  
Willingness To Use ◽  
Inform Decision Making

AbstractBackgroundThe COVID-19 Pandemic has popularized computer-based decision-support models as a tool for decision-makers to manage their organizations. It is unclear how decision-makers have considered these models to inform COVID-19-related decisions.MethodsWe interviewed decision-makers from North Carolina across diverse organizational backgrounds to assess major decision-making processes during COVID-19, including the use of modeling as an input to inform decision-making.ResultsInterviewees were aware of models during COVID-19, with some depending upon multiple models. Models were used to compare trends in disease spread across localities, allocate scarce resources, and track disease spread within small geographic areas. Decision-makers desired models to project disease spread within subpopulations and estimate where local outbreaks could occur as well as estimate the outcomes of social distancing policies, including consequences beyond typical health-related outcomes. Challenges to the use of modeling included doubts that models could reflect nuances of human behavior, concerns about the quality of data used in models, and the limited amount of modeling at the local level.ConclusionsThroughout COVID-19, decision-makers perceived modeling as valuable for understanding disease spread within their communities and to inform organization decisions, yet there were variations in organizations’ ability and willingness to use models for these purposes.

Multi-criteria spherical fuzzy regret based evaluation of healthcare equipment stocks

2020 ◽  
Vol 39 (5) ◽  
pp. 5987-5997
Author(s):  
Sezi Cevik Onar ◽  
Cengiz Kahraman ◽  
Basar Oztaysi
Keyword(s):  
Decision Making ◽  
Supply Chain ◽  
Supply Chains ◽  
Decision Model ◽  
Healthcare Systems ◽  
Decision Makers ◽  
Multi Criteria Decision Making ◽  
Health Related ◽  
High Level ◽  
Multiple Scenarios

The catastrophes due to widespread outbreaks create a long-standing distraction and have an accelerating transmission. The uncontrolled outbreaks cause not only health-related problems but also supply chain related problems. The outbreak caused by the coronavirus (COVID-19) shows how vulnerable the Healthcare systems and the supporting systems such as supply chains of the countries to such type of disasters. Keeping high levels of inventory, especially for healthcare products, can be beneficial to overcome such shortage problems. Nevertheless, keeping a high level of inventory can be costly, and the durability of the products creates a limit. The decision-makers have to carefully decide the inventory levels by considering many factors such as the criticality of the product and the easiness of producing the product. In this study, we try to develop a decision model for defining the inventory levels in Healthcare systems by considering multiple scenarios such as outbreaks. A novel spherical regret based multi-criteria decision-making approach is developed and used for evaluating the total regret of not keeping stock of the healthcare equipment.

scholarly journals Making Health Data Work for Maori

2020 ◽  
Vol 16 (2) ◽  
Author(s):  
Heather Gifford ◽  
Amohia Boulton ◽  
Lynley Cvitanovic ◽  
Pat Neuwelt ◽  
Tim Tenbensel
Keyword(s):  
Decision Making ◽  
Research Council ◽  
Data Interpretation ◽  
Health Data ◽  
Decision Makers ◽  
Second Phase ◽  
Health Research Council ◽  
Maori Health ◽  
Service Change ◽  
Inform Decision Making

This article explores the experience of health services decision makers using Mäori health data to inform decision making. It draws on selected findings from the second phase of a three-year Health Research Council-funded study and discusses how Mäori health data identification, data analysis and data interpretation processes are being used by decision makers to help to identify the most promising strategies to improve Mäori health. Data is critical to monitoring inequity and has the potential to drive health service change. However, improvement is needed at all steps in the decisionmaking process to better facilitate utilising data to leverage change in Mäori health outcomes.

scholarly journals Engaging Young People as Partners for Change: The ur Community Project

2019 ◽  
Vol 27 (1) ◽  
pp. 140-175
Author(s):  
Anthony Charles ◽  
Kevin Haines
Keyword(s):  
Decision Making ◽  
Young People ◽  
Local Level ◽  
Decision Makers ◽  
Specific Context ◽  
Research Dissemination ◽  
Community Project ◽  
Rights Of The Child ◽  
Children’S Voices ◽  
The Right

Article 12 of the un Convention on the Rights of the Child (uncrc) declares that young people have the right to express views and to have these taken into account when decisions are made that affect them. Yet, children’s voices are still not universally heard in policy and operational discourses. In many areas of service delivery in particular, young people remain disenfranchised, in spite of evidence which attests to their desire positively to engage with adult decision makers. Challenging the apparent discordance between the rhetoric relating to young people’s decision making and reality (as perceived by children), this article offers a new and innovative template for researching with young people as partners for change in the specific context of research dissemination. Seeking to enhance understanding and influence practice, the article sheds some much-needed light on how participation rights can be made “real” at a local level.

scholarly journals Proposal of a Holistic Model to Support Local-Level Evidence-Based Practice

2010 ◽  
Vol 10 ◽  
pp. 1520-1529
Author(s):  
Said Shahtahmasebi ◽  
Luis Villa ◽  
Helen Nielsen ◽  
Hilary Graham-Smith
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Evidence Based Practice ◽  
Local Level ◽  
Policy Formation ◽  
Decision Makers ◽  
Evidence Based ◽  
Holistic Model ◽  
Local Evidence ◽  
External Evidence

In response to a central drive for evidence-based practice, there have been many research support schemes, setups, and other practices concentrating on facilitating access to external research, such as the Centre for Evidence Based Healthcare Aotearoa, the Cochrane Collaboration, and the York Centre for Reviews and Dissemination. Very little attention has been paid to supporting internal research in terms of local evidence and internal research capabilities. The whole evidence-based practice movement has alienated internal decision makers and, thus, very little progress has been made in the context of evidence informing local policy formation. Health and social policies are made centrally based on dubious claims and often evidence is sought after implementation. For example, on record, most health care practitioners appear to agree with the causal link between depression and mental illness (sometimes qualified with other social factors) with suicide; off the record, even some psychiatrists doubt that such a link is applicable to the population as a whole. Therefore, be it through misplaced loyalty or a lack of support for internal researchers/decision makers, local evidence informing local decision making may have been ignored in favour of external evidence. In this paper, we present a practical holistic model to support local evidence-based decision making. This approach is more relevant in light of a new approach to primary health care of “local knowledge” complementing external evidence. One possible outcome would be to network with other regional programmes around the world to share information and identify “best” practices, such as the “Stop Youth Suicide Campaign”(www.stopyouthsuicide.com).

Climate-Sensitive Decisions and Time Frames: A Cross-Sectoral Analysis of Information Pathways in the Carolinas

2014 ◽  
Vol 6 (2) ◽  
pp. 238-252 ◽  
Author(s):  
Kirsten Lackstrom ◽  
Nathan P. Kettle ◽  
Benjamin Haywood ◽  
Kirstin Dow
Keyword(s):  
Decision Making ◽  
South Carolina ◽  
Information Exchange ◽  
Information Dissemination ◽  
Local Level ◽  
Decision Makers ◽  
Multiple Time ◽  
Climate Information ◽  
Wide Range ◽  
Time Frames

Abstract This paper analyzes the information dissemination pathways that support climate-sensitive decisions in North and South Carolina. The study draws from over 100 online questionnaires and follow-up interviews with leaders in the forestry, natural resources management, planning and preparedness, tourism and recreation, and water supply management sectors. Participants represented subregions within each state, different types of organizations, and organizations working at different geographic scales. The cross-sector comparison demonstrates diverse information uses across multiple time horizons and a wide range of sector-specific needs and factors that influence how and where decision makers obtain climate information. It builds upon previous research regarding climate decision making by providing a comprehensive view of the patterns of information exchange within a given region. Although all sectors draw from a common pool of federal agencies for historical and current climate data, participants consider sector-specific and local sources to be their key climate information providers. Information obtained through these sources is more likely to be trusted, accessible, and relevant for decision making. Furthermore, information sharing is largely facilitated via subregional networks, and accessing relationships with colleagues and local agency personnel is a critical component of this process. This study provides a more nuanced understanding of how climate information use varies across sectors and time frames and the decentralized nature of existing networks. These findings have important implications for future efforts to provide climate decision support to state- and local-level decision makers and highlight the need for networks and processes that meet diverse regional and sector concerns and contexts.

scholarly journals Improving the Slum Planning Through Geospatial Decision Support System

2014 ◽  
Vol XL-2 ◽  
pp. 99-105 ◽  
Author(s):  
S. Shekhar
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Support System ◽  
Support System ◽  
Expert Knowledge ◽  
Local Level ◽  
Decision Makers ◽  
City Development ◽  
Political Processes ◽  
Formal Framework

In India, a number of schemes and programmes have been launched from time to time in order to promote integrated city development and to enable the slum dwellers to gain access to the basic services. Despite the use of geospatial technologies in planning, the local, state and central governments have only been partially successful in dealing with these problems. The study on existing policies and programmes also proved that when the government is the sole provider or mediator, GIS can become a tool of coercion rather than participatory decision-making. It has also been observed that local level administrators who have adopted Geospatial technology for local planning continue to base decision-making on existing political processes. In this juncture, geospatial decision support system (GSDSS) can provide a framework for integrating database management systems with analytical models, graphical display, tabular reporting capabilities and the expert knowledge of decision makers. This assists decision-makers to generate and evaluate alternative solutions to spatial problems. During this process, decision-makers undertake a process of decision research - producing a large number of possible decision alternatives and provide opportunities to involve the community in decision making. The objective is to help decision makers and planners to find solutions through a quantitative spatial evaluation and verification process. The study investigates the options for slum development in a formal framework of RAY (Rajiv Awas Yojana), an ambitious program of Indian Government for slum development. The software modules for realizing the GSDSS were developed using the ArcGIS and Community -VIZ software for Gulbarga city.

scholarly journals People Behave as if they Anticipate Regret Conditional on Experiencing a Bad Outcome

2021 ◽  
Author(s):  
William Ryan ◽  
Stephen Baum ◽  
Ellen Riemke Katrien Evers
Keyword(s):  
Decision Making ◽  
Decision Makers ◽  
Relative Reduction ◽  
Risk Averse ◽  
Regret Theory ◽  
Risky Decision ◽  
Scarce Resources ◽  
Reduce Risk ◽  
Anticipate Regret ◽  
As If

Decision-makers often must decide whether to invest in prospects to reduce risk or instead save scarce resources. Existing models of risky decision making assume that decision-makers consider the absolute improvement in probabilistic chances (e.g., increasing a 10% chance of winning $10 to a 20% chance is roughly similar to increasing an 80% chance of winning $10 to a 90% chance). We present evidence that people instead behave as if they consider the relative reduction in bad outcomes (increasing a 10% chance to a 20% chance eliminates 1/9th of all bad outcomes, while increasing an 80% chance to a 90% chance eliminates 1/2 of all bad outcomes). This bias in the anticipation of preventable bad outcomes drives risk preferences that violate normative standards and results in the same participants behaving both risk-seeking and risk-averse within the same decision-making task. We discuss how regret theory can be adjusted to accommodate these results.

scholarly journals Veil-of-Ignorance Reasoning Mitigates Self-Serving Bias in Resource Allocation During the COVID-19 Crisis

2020 ◽  
Author(s):  
Karen Huang ◽  
Regan Bernhard ◽  
Netta Barak-Corren ◽  
max bazerman ◽  
Joshua D. Greene
Keyword(s):  
Decision Making ◽  
Resource Allocation ◽  
Moral Reasoning ◽  
Healthcare Professionals ◽  
Decision Makers ◽  
Medical Resources ◽  
Veil Of Ignorance ◽  
Younger Patients ◽  
Scarce Resources ◽  
The Veil

The COVID-19 crisis has forced healthcare professionals to make tragic decisions concerning which patients to save. Furthermore, The COVID-19 crisis has foregrounded the influence of self-serving bias in debates on how to allocate scarce resources. A utilitarian principle favors allocating scarce resources such as ventilators toward younger patients, as this is expected to save more years of life. Some view this as ageist, instead favoring age-neutral principles, such as “first come, first served”. Which approach is fairer? The “veil of ignorance” is a moral reasoning device designed to promote impartial decision-making by reducing decision-makers’ use of potentially biasing information about who will benefit most or least from the available options. Veil-of-ignorance reasoning was originally applied by philosophers and economists to foundational questions concerning the overall organization of society. Here we apply veil-of-ignorance reasoning to the COVID-19 ventilator dilemma, asking participants which policy they would prefer if they did not know whether they are younger or older. Two studies (pre-registered; online samples; Study 1, N=414; Study 2 replication, N=1,276) show that veil-of-ignorance reasoning shifts preferences toward saving younger patients. The effect on older participants is dramatic, reversing their opposition toward favoring the young, thereby eliminating self-serving bias. These findings provide guidance on how to remove self-serving biases to healthcare policymakers and frontline personnel charged with allocating scarce medical resources during times of crisis.

EMERGENCE OF “DRIVERS” FOR THE IMPLEMENTATION OF HEALTH TECHNOLOGY ASSESSMENT

2016 ◽  
Vol 32 (4) ◽  
pp. 300-306 ◽  
Author(s):  
Hector Eduardo Castro Jaramillo ◽  
Ornella Moreno-Mattar ◽  
Diana Osorio-Cuevas
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Political Support ◽  
Structured Interviews ◽  
Quality Of Data ◽  
Health Technologies ◽  
Cultural Aspects ◽  
Inform Decision Making

Background: Health technology assessment (HTA) examines the consequences of the application of health technologies and is aimed at better informing decision-makers. Over the past 30 years, different countries have implemented HTA organizations. Colombia established by law its own HTA agency (IETS) in 2011 which started operations in November 2012. The aim of this study was to assess the feasibility of conducting and using HTA to inform decision-making in this context. Through a qualitative approach, ten “drivers” emerged with the ability to help or hinder HTA development in this context: availability and quality of data, implementation strategy, cultural aspects, local capacity, financial support, policy/political support, globalization, stakeholder pressure, health system context, and usefulness perception.Methods: Semi-structured interviews were conducted with key HTA researchers, after following rigorous transcription, and thematic content analysis, those aspects that may be barriers or facilitator for HTA development and use in Colombia were identified.Results: Although HTA has become a tool to inform decision-making around the world, its use may vary according to setting. Determining those aspects which may enable or interfere with HTA development and use in Colombia may be useful for other countries when considering the establishment of HTA systems.Conclusions: The conceptual transferability of concepts like “drivers” with caveats may be of interest for similar settings trying to incorporate HTA processes and institutions into systematic decision-making.

scholarly journals Medicine and interest politics a study of decision-making processes in the area of vascular surgery in Norway

2020 ◽  
Vol 34 (4) ◽  
pp. 427-447
Author(s):  
Kjersti Wendt ◽  
Bjørn Erik Mørk ◽  
Ole Trond Berg ◽  
Erik Fosse
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Vascular Surgery ◽  
Public Involvement ◽  
Local Level ◽  
Clinical Care ◽  
Decision Makers ◽  
Content Type ◽  
Rational Distribution ◽  
Decision Making Processes

PurposeThe purpose of this paper is to increase the understanding of organizational challenges when decision-makers try to comply with technological developments and increasing demands for a more rational distribution of health care services. This paper explores two decision-making processes from 2007–2019 in the area of vascular surgery at a regional and a local level in Norway.Design/methodology/approachThe study draws upon extensive document analyses, semi-structured interviews and field conversations. The empirical material was analyzed in several steps through an inductive approach and described and explained through a theoretical framework based on rational choice (i.e. bounded rationality), political behavior and institutionalism. These perspectives were used in a complementary way.FindingsBoth decision-making processes were resource-intensive, long-lasting and produced few organizational changes for the provision of vascular services. Stakeholders at both levels outmaneuvered the health care planners, though by different means. Regionally, the decision-making ended up in a political process, while locally the decision-making proceeded as a strategic game between different departments and professional fields.Practical implicationsDecision-makers need to prepare thoroughly for convincing others of the benefits of new ways of organizing clinical care. By providing meaningful opportunities for public involvement, by identifying and anticipating political agendas and by building alliances between stakeholders with divergent values and aims decision-makers may extend the realm of feasible solutions.Originality/valueThis paper contributes to the understanding of why decision-making processes can be particularly challenging in a field characterized by rapid technological development, new treatment options and increasing demands for more rational distribution of services.

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