Role of Cognitive Mapping in Health Care Management Decision

Role of Cognitive affair in health C argon Management DecisionDescribe and discuss the role of cognitive routine in health care management conclusiveness reservation. takeation of Cognitive roleCognitive social function is an opeproportionnal research technique that consists of creating a graphical representation of a persons (or groups) way of thinking al near an issue, and where directionality in spite of appearance the map is assumed to imply perceived creator among the concepts (Eden, 2004). The proposed value of the graphical representation, as argued from the field of political science, is that it submits it easy to for any peerless to canvas how concepts and causal relationships are related, and appreciate the overall bodily structure of all the assertions (Eden 2004 cited Axelrod 1976, p. 676).It is one mechanism of system dynamics simulation simulation that generally came around as a re trifleion to failure of traditional approaches to capture interactions w ithin complex problems in social systems (Edkins et al. 2007 cited Checkland 1981). It avoids the common research process colliery of reductionism by intromiting multiple conflicting views to be revealed and, providing a comprehensive evidence of the participants perspectives but keeping all details to represent beliefs that are most distinguished to stakeholders represented (Duryan, Nikolik, Merode, 2015 Eden Ackermann, 2004).Cognitive map was initially introduced as a manner for problem epitome. But recognizing its value, it has then found roles in performance measurement, decision making, and strategy formulation. Eden and Ackermann (1991) expounded on the possible subprograms of this technique in becoming an instrument for developing consensus about shared goals, providing structure to multiple and conflicting aspects of an issue, informing negotiation, and suggesting actions to resolve issues.Use of Cognitive Mapping in Health CareCognitive mapping is argued to be ta ke up for messy situations wherein stakeholders do not understand the problem or interpret them diversely, and often do not realize it (Mingers 2008 cited Ackoff 1979a). Healthcare decision making falls into this realm as it has always been complicated by randomness asymmetry, trade-offs between efficiency and equity, or moral ambiguity that become true sources of uncertainty and debate among stakeholders. In fact, the first uses of cognitive mapping in operational research were in healthcare, education, and defense (Eden Ackermann, 2004).Mingers (2008) described an example in 1997 Manchester, where the UK Health Authority commissioned the Salford Community Trust to develop an corporate approach to childrens services. Mingers argued that temporary hookup the project seemed straightforward, it turned out to be a messy problem as there was no agreement on the definitions of service specifications, services to be included, direction of the strategy, and how the project should be tackled. at that place were also many stakeholders involved in the issue (i.e. government, doctors, patient groups, industry) that had really strong opinions about the project. If the group were to make a plan found on epidemiology, practice guidelines, budget constraints and otherwise mathematical factors alone, without taking into reflexion the stakeholders differing views, the proposed program would likely fail during implementation.Situations like these are common in healthcare decisions given the complexity of issues faced at doctor-patient, organizational, and national- polity level. Mathematical and statistical method actings provide a narrow focus on measurable aspects of decision that fails to catch the reasoning, motivations, and interactions relevant to achieving these outcomes. Problem structuring through cognitive mapping provides an hazard for healthcare decision makers to systematically measure these missing interactions and assess their bushel to the goal un der assessment (Pidd, 2004).Sachdeva et al (2007) explored the added value of cognitive mapping from traditional approaches in understanding patient flow delays in a Pediatric Intensive Unit (PICU) of a Childrens Hospital in Wisconsin, USA. warm operations research (OR) government issues development modelling were persuasive, but became inadequate to result to change given politically sensitive issues that arose. Soft OR using cognitive mapping that was done identified new issues and offered a much holistic and comprehensive understanding of the issues complexity that helped persuade decision makers to act on the recommendations. daddyThe most common technique for cognitive mapping is the Strategic Options Development Method (SODA). SODA is an ethnographic method derived from interviews that are intended to represent the participants pillow slipive worlds the theoretical basis of which is explained by individualized construct theory (Eden 2004 cited Kelly 1995) wherein people make sense of their world by seeking to manage and control it.SODA uses a formal modelling technique with rules for its development as described by a exploiter guide developed by Eden and Ackerman (Ackermann et al., 1991). The transcripts of the interviews are separated into pitiful distinct phrases (nodes) that eventually get sorted as goals, strategic directions, or potential plectrons. Fidelity in transcription is imperative to represent the participants intentions and to advocate ownership of the resulting map created. The concepts are linked (arrows) to see to it accurate domination of concepts, directionality and opposing poles to create the overall structure. While the map is an important output of its own, these can also be subject to further abstract to gain deeper insight, such asAnalysisMap CharacteristicsGoalsHead epitomeNodes with only incoming arrowsTo identify end goals or effects parsimoniousness analysisNumber of mentions of the conceptsTo determine potenti al key issues from the perspectives of the participants that may lack further examinationCentrality analysisNumber of links to the concept, or ratio of arrows to conceptsTo measure the importance and complexity of the concepts implication chainHierarchical stud analysisNumber of concepts in chain or arguments linked to optionTo identify most potent options or valued outcomes to influence on the goalsPotency analysisNumber of goals each option supportsTo prioritize options with consequences for the biggest military issue of key issuesComposite tail analysisRanking of potency analysisTo determine the single action that may cause multiple goals to be achievedSource Summary by AuthorHealthcare Example of use SODAA case study by Duryan et al. (2015) on quick deterioration care in Netherlands made use of SODA to determine factors that adversely affect delivery of patient-centered care as evidence for prospective resource allocation. Following SODA guidelines, the team up conducte d one-on-one, semi-structured, hour-long interviews with the managers and patient group leadership within one division of a residential care facility. Initially, they were idea to have contrasting goals financial sustainability for the managers and quality of care from resource constraints for the patients. utilize the Decision Explorer software, cognitive maps were created and merged to reflect the combined views. place assumptions were then discussed and verified, and follow-up focus group discussions with different subgroups of the patients (young vs old) and their families were done to brush up the ideas represented by the initial group. The merged map was then subject to head, domain, centrality, potency analysis, and compound tail analysis.Results showed that group leader freedom to make decisions, flexible shifts, and time spent with patients were the most potent options/solutions, and therefore needful quick action by the managers. According to the researchers, the e xercise successfully facilitated detailed analysis of the problem and fostered ownership of the proposed solutions by all stakeholders. Seeing the different/ opposing thoughts organized and their end-goals similar also helped reach consensus and manage disagreements.Expansions of SODAWhile SODA provides solutions to complex strategic processes, it lacks a mechanism to sanction for agreement among the strategies to be developed. SODA was developed further into JOURNEY devising (JOintly Understanding Reflecting and NEgotiating strategY) to become a process-oriented and management-science strategy by using the composite map in a workshop setting as a tool to help negotiation and explore policy options that will allow the issue to be intelligently resolved (Mingers, 2008). Another method, the Oval Mapping Technique (OMT), creates a cognitive map but through a highly participative strategy workshops.White et al (2007) used JOURNEY do to collect and define humans set and voices amon g stakeholders involved in a community hospital project in South London. Intergroup workshops were done in phases to map/graph the issues and options related to the decision. The process resulted to wide borrowing of the recommendations and an appointed plan enacted by the Department of Health. This is one among many examples of the opportunity to use these newer OR tools in healthcare strategy management planning at both organizations and the national policy arena.LimitationsCognitive mapping provides an opportunity to contest with messy problems in a systematic way, but general acceptance of it as a method is still lacking. Mingers (2008) explains that especially in the unify States, it is viewed as a soft OR method not regarded for issue in top journals nor teaching in courses among top schools.The concerns on subjectivity of results remain valid that even though the process is systematic and rigorous, they are still variable and dependent on both study function and recrui tment. The cognitive maps developed will depend largely on the alternative of participants, their active participation, their personal motivations, and the assumption that they are adequately informed of the problem. And the hazard of one person skewing the result is high given the small examine (i.e. 4-10 people) used for these activities. The method also assumes adequate facilitation by the research team to determine the key nodes and domains, which may not always be the case.Also, while cognitive mapping provides a snapshot of the decision making, it does not provoke understanding over time periods and cannot be used to derive numerical assessments of its impact (Pidd, 2004).Cross-validation or triangulation using many models of the same issue may be done to increase its validity (Abernethy et al, 2005). Combination of soft and voteless methodologies is believed to increase acceptance and sustain organization change especially in healthcare settings (Sachdeva et al., 2007). And, it should always be used in conjunction with other methods for research data gathering, monitoring, performance measurement, or decision support.Lastly, for cognitive mapping to be useful in decision support, it requires the decision makers to understand the method/process, recognize the value of the issues at the front line, take the results seriously, and act on the recommendations. It is therefore crucial for any research team using this method to help the decision makers appreciate the approach and engage with the recommendations.ReferenceAbernethy, M. A., Horne, M., Lillis, A. M., Malina, M. A., Selto, F. H. (2005). A multi-method approach to building causal performance maps from expert knowledge. Management account Research, 16(2), 135-155. https//doi.org/10.1016/j.mar.2005.03.003Ackermann, F. ., Cropper, S. A., Eden, C. L. (1991). Cognitive Mapping for Community operating(a) Research-A Users Guide. (E. 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