Review of Experimental Studies in Social Psychology of Small Groups When an Optimal Choice Exists and Application to Operating Room Management Decision-Making

Abstract

Because operating room (OR) management decisions with optimal choices are made with ubiquitous biases, decisions are improved with decision-support systems. We reviewed experimental social-psychology studies to explore what an OR leader can do when working with stakeholders lacking interest in learning the OR management science but expressing opinions about decisions, nonetheless. We considered shared information to include the rules-of-thumb (heuristics) that make intuitive sense and often seem "close enough" (e.g., staffing is planned based on the average workload). We considered unshared information to include the relevant mathematics (e.g., staffing calculations). Multiple studies have shown that group discussions focus more on shared than unshared information. Quality decisions are more likely when all group participants share knowledge (e.g., have taken a course in OR management science). Several biases in OR management are caused by humans' limited abilities to estimate tails of probability distributions in their heads. Groups are more susceptible to analogous biases than are educated individuals. Since optimal solutions are not demonstrable without groups sharing common language, only with education of most group members can a knowledgeable individual influence the group. The appropriate model of decision-making is autocratic, with information obtained from stakeholders. Although such decisions are good quality, the leaders often are disliked and the decisions considered unjust. In conclusion, leaders will find the most success if they do not bring OR management operational decisions to groups, but instead act autocratically while obtaining necessary information in 1:1 conversations. The only known route for the leader making such decisions to be considered likable and for the decisions to be considered fair is through colleagues and subordinates learning the management science.

Strategies for Net Cost Reductions with the Expanded Role and Expertise of Anesthesiologists in the Perioperative Surgical Home

“…10 Once the OR Medical Director is doing these activities, the anesthesiologist can also be engaged in other substantial perioperative cost reduction activities, such as leading surgical group discussions on implant and disposable costs, purchasing, and preference cards. 36,50,51,134,[138][139][140] Using both a payment (price) cap model when negotiating with manufacturers 141 and providing relative cost information to surgeons when >1 type of implant may be suitable 142 are multiple specialty interventions that can benefit from physician leadership. Computational and other engineering methods can be used to optimize numbers of preference cards.…”

“…32,42 Anesthesiologists' Role in OR Management An OR Medical Director having knowledge of scientific OR management is essential to achieve the cost reduction. 50 This anesthesiologist plays a pivotal role in achieving cost reduction by being responsible for staff scheduling and for case scheduling starting a few days before surgery. 50,51 This responsibility is important in part because OR nursing directors often are not rewarded for making decisions that increase anesthesiologists' productivity.…”

“…50 This anesthesiologist plays a pivotal role in achieving cost reduction by being responsible for staff scheduling and for case scheduling starting a few days before surgery. 50,51 This responsibility is important in part because OR nursing directors often are not rewarded for making decisions that increase anesthesiologists' productivity. 51 The relative costs based on wages are anesthesiologists >nurse anesthetists >OR nurses >surgical technologists, and thus, the bottlenecks economically to providing care generally should also be in that sequence.…”

“…The OR Medical Director also can work as a facilitator of group level decision-making, 50 guiding surgeons in adjusting their days of surgery, if physical hospital bed capacity (wards or intensive care unit) is the perioperative bottleneck. By physical, we mean not nurses but numbers of beds.…”

Influence of Data and Formulas on Trust in Information from Journal Articles in an Operating Room Management Course

“…[5][6][7][8][9][10][11][12] Such tasks are intellective a and generally not highly demonstrable (i.e., personnel can generally only understand and apply the decision-making process if they have attained knowledge through an educational course or research). [13][14][15][16][17][18] In such settings, the quality of leadership decision-making is better when following an autocratic style rather than a participative group style. 18 Autocratic decision-making calls for managers to solicit and consider feedback from stakeholders in the decision outcome and then to make the decision themselves.…”