Best Practice. Decision Making Framework in Healthcare

The College of Occupational Therapists of Ontario developed a five-step process for making decisions by occupational therapists. These specialists face all kinds of problems that may require simple or complex decisions. This decision-making framework offers key recommendations about each step of the process.

Step 1. Describe the Situation
The therapists are advised to consider several questions that will help them to understand the situation: What are the key elements of the situation? What are the potential risks associated with the situation? What is the decision to be made? Are there personal assumptions, biases, or cultural differences that could impact decision making?

Step 2. Use the Fundamental Checklist
Six contributing factors that influence the decision-making processes are presented in this step: 1) Client and Family; 2) Organization and Practice Setting; 3) Theories and Evidence; 4) Professional Regulations; 5) Healthcare Team; 6) Law.

Step 3. Consult Others
This step brings forward the importance of different viewpoints and expertise. Some of the parties that may be involved in the decision process are colleagues, supervisors, lawyers or legal professionals, ethicists or an ethics board, regulatory bodies, other clinical or non-clinical professionals or subject matter experts.

Step 4. Identify Options and Choose the Best Action
The main points in this stage are: What makes this the best approach? Does the rationale sound reasonable when you say it aloud? What is your professional instinct telling you? How to recognize and address consequences and document the decision process?

Step 5. Evaluate the Decision
In this phase, the therapist must identify the lessons learned.

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