Services to support complex decision making

In collaboration with Broca & Wernicke, STBY investigated the complex decision making processes within hospitals on the application of surgical treatments. We interviewed people throughout the organisation, from surgeons to medical support staff and financial and operational managers. We found that people’s rationale for the availability and application of specific treatments can differ considerably, depending on the agenda and responsibilities that come with their position. Where medical effectivity and patient comfort is the ultimate driving force for some, costs and operational efficiency can be just as important for others.

Although the decision to apply a specific treatment is ultimately made in the operating theatre, the condition that the necessary tools and materials are in stock and close at hand usually depends on a delicate process of planning and negotiation. Since these decisions can be a matter of live and death, hospitals are very keen and experienced in making sure these processes are not muddled by personal hang ups or whims. This obviously makes a lot of sense from the perspective of the patients, and the society as a whole. But the formal procedures do put a strain on the people involved, as they need to integrate the negotiations into their busy jobs and sometimes struggle to get their individual perspective across in the multi-layered organisation.

This project was part of the ongoing collaborative research programme ‘Patient Perspective’, initiated by STBY and Broca & Wernicke in 2009. This most recent study, at the Erasmus Hospital in Rotterdam, was geared towards advising Nycomed on how to evolve their innovation process from mere product development to offering more holistic services to their clients’ organisations, such as supporting various aspects of complex decision making processes. This broader focus would set them up to work more in partnership with hospitals than purely as a supplier of goods. From the perspective of patients this is surely a comforting thought.