DDBA 8560 Week 5 Decision Options Analysis Example

Four Ways to Shorten the MRI Wait, Scored in One Vocabulary: An Options Analysis for Brookfield Outpatient Imaging That Projects the Current Arrangement Forward, Reports Where the Search Stopped and Why, and Keeps Its Ranking Provisional

Student Name

Walden University

DDBA 8560: Seminar in Healthcare Managerial Decision Making

Instructor Name

Month Day, Year

Four Ways to Shorten the MRI Wait, Scored in One Vocabulary: An Options Analysis for Brookfield Outpatient Imaging That Projects the Current Arrangement Forward, Reports Where the Search Stopped and Why, and Keeps Its Ranking Provisional

How the Options Were Found

Simon (1955) argued that decision makers rarely search for every alternative; they stop at the first one that clears their threshold, a process he called satisficing. This analysis states where its own search stopped. Candidates came from three places: interviews with the imaging director, two lead technologists and the scheduling supervisor; the practices of two peer hospital imaging services; and a session with the decision group described in Week 4. Seven candidates emerged. Three failed screens: shortening scan protocols, which the radiology group controls; staffing evening shifts with technologists not yet credentialed in MRI; and sending overflow patients to an independent center whose radiologists fall outside the reading contract. Four passed. The search ended there because the remaining ideas raised in the session, such as Sunday hours, were variants of options already listed and would score similarly.

The Four Profiles

Every profile follows one template, with fields in a fixed sequence, and reports results in the units chosen in Week 4.

Option A, evening hours on the 3 tesla scanner. Operate Monday through Thursday, 5:00 to 9:00 p.m., adding 16 scanner hours a week. Effect on wait: about 11 days after six months, assuming 80 percent of evening slots fill. Annual incremental cost: about $274,000. Staff burden: about 1,660 technologist hours a year outside the standard shift. Access for working patients: about 13 percent of routine slots fall in the evening, beyond the usual office day. Time to start: 14 weeks. Screens: passes all four, with MRI safety staffing included in the cost.

Option B, no-show reduction and targeted overbooking. Add automated text and phone reminders and overbook slots for patients with a history of missed appointments. Effect on wait: about 19 days, recovering about 40 slots a month by cutting no-shows from 9 to 5 percent. Annual incremental cost: about $58,000. Staff burden: none. Access: none added. Time to start: 6 weeks. Screens: passes all four.

Option C, extend the mobile scanner lease to four days. Add two days a week of mobile scanning when the lease allows amendment. Effect on wait: about 10 days, adding about 138 scans a month. Annual incremental cost: about $468,000, mostly lease fees. Staff burden: none outside the standard shift, though about 2,080 daytime hours are added. Access: none added. Time to start: 20 weeks. Screens: passes all four.

Option D, the current arrangement. Make no change. Effect on wait: about 31 days in a year, because demand is growing about 6 percent a year while capacity is fixed. Annual incremental cost: none. Staff burden: none. Access: none added. Time to start: not applicable. Screens: passes all four.

Scoring

[after]

Each criterion is scored from 0 at its worst plausible level to 100 at its best, using the ranges set in Week 4, and the weights are carried over unchanged, following the additive approach to multiple objectives that Keeney and Raiffa (1976) set out.

Table 1

Scores on Each Criterion and Weighted Totals

What the Scores Show

Option A leads, but by about six points over B and eight over C. That margin is narrow. A depends on evening demand that has not been tested; B is cheap and quick but does not reach the access target; C reaches the target fastest in wait but at the highest cost and with no gain for working patients. The current arrangement scores lowest because the wait will grow.

Why the Ranking Stays Provisional

Nutt (1999) found that decision makers often commit to the first attractive option and stop examining it. The leading option's score depends heavily on the assumption that 80 percent of evening slots will fill. If that assumption is wrong, B or C could lead. The next step is to test it, not to recommend A.

Can Options Be Combined?

B could be combined with A or C, since reminders and overbooking do not conflict with added hours. A combined option would need its own profile rather than the sum of two, because recovered daytime slots would reduce the demand for evening ones.

Limits

Wait estimates come from a simple queue projection using last year's demand. Costs are estimates refined in the cost case.

References

Keeney, R. L., & Raiffa, H. (1976). Decisions with multiple objectives: Preferences and value tradeoffs. Wiley.

Nutt, P. C. (1999). Surprising but true: Half the decisions in organizations fail. Academy of Management Perspectives, 13(4), 75-90. https://doi.org/10.5465/ame.1999.2570556

Simon, H. A. (1955). A behavioral model of rational choice. Quarterly Journal of Economics, 69(1), 99-118. https://doi.org/10.2307/1884852