Data Driven Decision Making for Hospitals Part 2 – The Decision Framework

A decision is a choice made by a decision maker that results in a change to a desired state. For example, the decision to expand hospital services is driven by a desire to leverage infrastructure and resources to meet a demand and improve revenue. 

  • The Desired State: Meet market needs, improve revenue.
  • Internal Resources: Infrastructure, staff
  • External Resources: Demographics, Market, Regulations

Another example of implementation of the decision framework in the hospital setting is the  improvement in operational efficiency.  The data required for this decision is multi-faceted. EMRs need to be examined for patient classification, schedules developed for optimization  based on patient classification, matching resource needs and occupancy times are but a few of the resources to be pooled for assessment and interdependencies. This leads to the “right” patient optimally scheduled to efficiently use the available resources.

  • The Desired State: Optimize Resource Scheduling
  • Internal Resources: Infrastructure, Staff
  • External Resources: Surgeons, Reimbursement Rates, Demographics, Patient Status

Defining the desired state is a difficult task, but the framework described below makes this task manageable. The following diagram illustrates a layered framework that supports a target desired state.

The Decision Framework

Each layer is detailed below.


The first step in the decision process is understanding your decision-making context. There are two components to context – internal constraints and external constraints. For hospitals, examples of external constraints include regulatory requirements, equipment and supply costs, and market shifts. Examples of internal constraints include hospital policies, stakeholder interests, resources, and financial state.

The next step is to understand the content that reflects the decision-making context. This content comes in three forms – Data, Experience, and Expertise. Data could be regulatory documents, policy documentation, patient feedback, and financial information. Experience refers to the relationships and knowledge of processes that long-term employees hold. Expertise refers to domain experts who understand the relationships between data types and the ‘why’ of policies and processes.

The nature of this content then informs the desired state for the decision. Since any step in this process can inform an earlier step, you’ll find that the Decision Process may require a few passes around the cycle to refine the outcome.


All decisions carry value. The value of the decision is important to the decision maker and the hospital organization.  Understanding how the decision relates to the financial health of the hospital is integral to the decision process.  The argument often focuses on short versus long term organizational impact.

Understanding the decision impact on all stakeholders is critical.  While the decision may be a simple “yes” or “no”, it’s impact will be felt in all areas of a hospital with more immediate  impact on the stakeholders closest to the impact point.


All decisions involve risk and a decision maker must consider both the decision maker’s and organization’s sensitivity to risk. The decision maker may be risk averse due to the immediate impact of failure on his well being.  If the organization is focused on immediate negative consequences of failure, then the appetite for risk in the decision making process of the individual becomes extremely limited.  Decision makers must quantify risk so the organization understands how undesired outcomes will be addressed.

The ability to aggregate data from multiple sources and diversify the decision allows the decision maker to de-risk the decision process. NoviLens allows the hospital to “join” or fuse the data from the external environment with internal data. Hospitals can no longer view data stored in various databases as “silos” owned by one particular unit but rather as a resource for extracting “features” or facts necessary for decision making.  As facts are collected and assessed, the risk inherent in the decision will decrease.

In the next post, we’ll cover the importance of maintaining critical thought through the decision making process in a hospital.

NoviLens is an appliance for data driven decision making. NoviLens handles the tedium of the computing components of the process and frees up the decision maker to focus on their problem solving tasks.

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