How to solve decision deadlock with team-based decision making

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Content submitted by Thrive Pet Healthcare, a dvm360® Strategic Alliance Partner

The situation

Most of us have been there: The team needs to make a decision. The topic requiring the decision involves multiple key stakeholders, maybe even more than 1 group in the hospital. No matter how much time and effort the team members expend, they cannot reach a satisfactory decision.

Inevitably, everyone turns to the “boss” to make the final call. However, once it has been made, few people like the decision. Blame, whether spoken or not, is all too frequently common.

So, what’s the problem?

Traditionally this situation has been analyzed as a problem of leadership, teamwork, or both. The solution often employed is to bolster the team building and communication skills of the leader to support establishing mutual trust of the team. This strategy misses the real problem, which lies in the decision-making process itself. The deadlock is inherent when a group attempts to arrive at a collective preference predicated on all of the individual preferences.

There are practical measures designed to break the impasse. These measures enable teams break the cycle of the blame game and move to a no-fault style of decision making.

Breaking the cycle and managing the impossible

Let’s look at how to implement this using a real example from the trenches:

Acknowledge the problem

Treatments for inpatients are sometimes delayed, getting missed, or happening slightly differently than the attending veterinarian intended. The team comments that this is the result of everyone being very busy and finding it hard to understand things on the very old, somewhat out-of-date inpatient treatment sheets that currently hang on every cage. Everyone believes a new system is needed.

Articulate clearly what outcome you are seeking and achieve alignment on desired outcome

It’s essential to keep discussion of the desired outcome distinct from discussion about how to achieve it. In this example, the team is aligned that all treatments should be administered to every patient on time and accurately using a system that is efficient for the nursing staff.

Ask team members to provide their proposed solution(s) for achieving outcomes

Every key stakeholder on the team should be encouraged to submit their idea(s) to accomplish the goal on which the team aligned. Some team members want a new treatment sheet to hang on the cage with more ergonomic formatting. Some want to move to an electronic paperless treatment sheet. Some want to concurrently leverage a dry erase board to note which patients have any treatments every hour to draw attention to those cages. The options are plentiful and varied.

State each option’s pros and cons and devise new options that preserve the best features of existing ones.

Surface preferences early and determine if there is flexibility in those preferences. These strategies will reduce the likelihood of a stalemate.

The team discusses every option presented, recording identified pros, call outs, and resources needed to implement each option. Team members also give their rankings of options and call out any unmovable barriers, dubbed walls, to implementing any options. Walls cannot be moved, but fences can.

In this discussion, a wall was noted for the option which called for completely electronic iPad-based treatment system, as the hospital budget would not afford that this year. A fence barrier was noted with some technicians for the option to move to a new hanging treatment sheet with a concurrent white board for central ICU use. These technicians indicated they did not favor having to check 2 different places—the hanging treatment sheets and the white board—but they would be willing to consider the perceived redundancy if the team felt this would be most likely to achieve aligned outcome of ensuring 100% accurate and timely treatments for all patients all the time.

Be prepared to make final decision as the 51% stakeholder

There is no such thing as true decision by committee. In most cases, someone needs to be the person to make the final call. This person, usually the team leader, boss, or manager, should be identified at the beginning of the decision-making process. When the steps above are complete, the 51% stakeholder makes the final call.

In our example, the team was fairly evenly split between a newly designed cage-side treatment sheet and concurrent use of that sheet plus a white board in the central ICU to notate which patients have treatments every hour. The team leader decided to opt for the latter solution, sharing with the team the belief that this option would be most likely to achieve aligned desired outcome of the team without too much workflow inefficiency.

Circle back to see how things are working for the team and iterate as needed

Be sure the team knows at the time the decision is made what the exact plan will be to accomplish this. In this example, our team leader advised the team that their individual feedback would be solicited on the success of the new system through several different mechanisms.

After one month using the new system, a survey would be sent to all team members soliciting feedback. At this time, the number and percentage of delayed, missed, and inaccurate treatments would also be calculated and compared to these numbers using the old system. Lastly, there would be an open-door policy for feedback from every team member in person, voice or through email anytime.

The ground rules

Ground rules are essential to create safety and a sense of “terra firma” for the team.

It’s essential there is no triangulation or side talk during decision making deliberation. Decision making conversations should be transparent and direct. It is also important that decision making deliberations occur over an appropriate time frame; decision making should not be rushed, but there should be an achievable timeframe set to conclude deliberations and align on decision.

Be sure the team knows any decision will have follow-up with iteration as needed. Set defined time points at which a new process implemented as a result of a team decision will be evaluated to assess effectiveness, efficiency and accuracy. Don’t be afraid to pivot and re-evaluate the decision if it is not executing as intended. Team-based decision making is not about whose idea was right; it is about what decision achieves desired outcome most completely and with ease.

The bottom line

A team can’t make effective decisions if its members don’t trust one another or if they fail to listen to one another. Open, transparent communication and follow through with stated actions are key as well. Using these tips, you can lead your team to make effective, judgement free decisions to elevate team culture, morale, and engagement to benefit your patients and pet parents.

Futher reading

Frisch B. When Teams Can’t Decide. Harvard Business Review. November 2008. Accessed September 7, 2022. https://hbr.org/2008/11/when-teams-cant-decide