Week 11: Decision-Making 101 決策入門
Time: 4 minute video
Category: Strategy 策略
Most bad decisions do not begin when we choose the wrong option. They begin earlier, when we never clearly say what decision we are making, when we wait too long for perfect information, or when discussion keeps going but no one actually decides. This week’s tool is simple: DOOR. It helps you make decisions that are clear, timely, and reviewable.
很多不好的決定，不是從「選錯答案」那一刻才開始的。它通常更早就開始了：我們沒有先把「今天到底要決定什麼」講清楚，或是一直等完美資訊，或是大家一直在討論，但最後沒有人真的做決定。本週的工具很簡單：**DOOR**。它幫你做出清楚、及時、而且可以回頭檢視的決定。
English Version
中文版 (AI)
Summary of Video
Why does this matter for leaders at KFSYSCC?
Leaders in a hospital make decisions every day under pressure. Staffing, scheduling, approvals, escalation, and workflow changes often cannot wait for perfect certainty. If the decision is unclear, people move in different directions. If the decision comes too late, the cost usually grows. A basic decision process helps leaders move faster without becoming careless.
When would you use this?
Use DOOR when:
you need to choose between two or more real options
discussion is happening, but no one is naming the actual decision
people are waiting because they think “we need more information”
a backlog, delay, or capacity issue needs a practical response
the decision matters enough that you want a review date, not just a one-time opinion
What are the key phrases from this video?
Clear. Timely. Reviewable.
You will not have perfect information.
Define the decision.
Compare 2 options.
Check 1 risk.
Set 1 review date.
How would you describe this tool in 30 seconds?
DOOR is a fast decision tool. First, define the decision in one sentence. Second, write down at least two real options. Third, ask one risk question: if this fails in 30 days, what will probably be the reason? Finally, choose the option, name the owner, and set a review date.
影片摘要
為什麼這對和信醫院的領導者很重要？
在醫院裡，主管每天都要在壓力下做決定。人力、排程、核准、升級處理、流程調整，常常都不能等到完全確定才處理。如果決定不清楚，大家就會往不同方向走；如果決定太晚，代價通常只會變大。基本的決策流程，能讓主管更快前進，又不會變得草率。
什麼時候會用到這個工具？
以下情況很適合用 DOOR：
你真的要在兩個以上的選項之間做選擇
大家一直在討論，但沒有人把「真正的決定」講出來
大家一直卡在「還要再等資訊」
積壓、延誤、容量問題需要一個實際做法
這個決定夠重要，你不想只做一次性判斷，而是想訂一個回頭檢視時間
這支影片的關鍵句是什麼？
清楚、及時、可回頭檢視
你不會有完美資訊
先把決定講清楚
比較 2 個選項
檢查 1 個風險
訂 1 個回顧時間
用 30 秒怎麼描述這個工具？
DOOR 是一個快速決策工具。第一步，用一句話講清楚今天要決定什麼。第二步，至少寫下兩個真實可行的選項。第三步，先問一個風險問題：如果 30 天後這個做法失敗了，最可能的原因是什麼？最後，做出選擇、說清楚誰負責、並訂好回顧時間。
Scripts for Leaders
Keep these short. The goal is not to sound impressive. The goal is to make work easier, calmer, and clearer.
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Before we continue, let’s define the decision.
Today we are deciding ______.
We need to decide by ______.
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We’ve heard the main points.
What exactly are we deciding today?
Let’s say it in one sentence.
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Right now I only hear one path.
What is one real alternative?
If we had to compare two options, what would they be?
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Let’s do one quick risk check.
If this fails in 30 days, what will probably be the reason?
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We are choosing Option B for two weeks.
Maria owns this.
We will review the result next Friday at 4 PM.
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We do not have perfect information yet.
That is normal.
With what we know today, what is the best decision we can make now?
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We are not ready to decide today.
So let’s be clear: what information is missing, who will get it, and by when?
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To confirm: today’s decision is ______.
The owner is ______.
The review date is ______.
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discussing the problem without naming the decision
waiting for complete certainty
having only one “option” and calling it a decision
choosing something but never setting a review point
給主管的對話腳本
這些句子請盡量簡短。目標不是「講得很厲害」，而是讓工作更順、更穩、更清楚。
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在繼續討論前，我們先把決定講清楚。
今天我們要決定的是 ______。
最晚要在 ______ 前做出決定。
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重點我們都聽到了。
那我們今天到底要決定什麼？
請用一句話講出來。
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我現在只聽到一條路。
另一個真正可行的選項是什麼？
如果一定要比較兩個方案，會是哪兩個？
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我們先做一個很快的風險檢查。
如果 30 天後這個做法失敗了，最可能的原因是什麼？
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我們先選 B，做兩週。
這件事由 Maria 負責。
我們下週五下午 4 點回頭看結果。
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我們現在還沒有完美資訊。
這很正常。
用今天已經知道的資訊，現在最好的決定是什麼？
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我們今天還不能做決定。
那就要講清楚：缺的是什麼資訊、誰去補、什麼時候補回來？
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我們確認一下：今天的決定是 ______。
負責人是 ______。
回顧時間是 ______。
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一直談問題，卻沒把決定講清楚
一直等到完全確定才行動
其實只有一個選項，卻以為自己在做決策
做了選擇，但沒有訂回頭檢視時間
Supporting Research
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Decision science has long emphasized that people make choices under limits of time, information, and cognitive capacity. Herbert Simon described this as bounded rationality. In healthcare, uncertainty is normal, not a sign of failure. Research on option generation argues that generating real alternatives is an important part of decision-making, not just comparing options after someone else names them. Premortem methods are used to surface hidden risks before action.
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A basic process does not guarantee a perfect decision. Results still depend on judgment, context, workload, and the quality of available information. Also, a good decision process cannot replace follow-through. If the owner, review date, or criteria are unclear, the decision may still fail in execution.
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At KFSYSCC, we use DOOR to keep decisions practical. We want leaders to say the decision clearly, compare at least two real options, name one key risk, and set one review point. The goal is not perfect certainty. The goal is a decision that is good enough to act on, and clear enough to review.
支持性研究
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決策研究很早就提醒我們，人是在時間有限、資訊有限、認知資源有限的情況下做選擇的。Herbert Simon 把這叫做有限理性。在醫療場域，不確定性是正常的，不代表你做得不好。關於選項生成的研究也指出，真正的決策不只是比較別人已經提出的方案，而是先生成真正可比較的替代選項。Premortem（事前失敗檢查）則是用來在行動前，把可能被忽略的風險先拉出來。
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再好的基本流程，也不能保證完美決定。最後的品質仍然會受到判斷力、情境、工作量、和資訊品質影響。另外，好的決策流程也不能取代後續執行。如果負責人、回顧時間、或判斷標準不清楚，決定還是可能在執行時失敗。
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在和信，我們用 DOOR 讓決策更實際。主管要先把決定講清楚，至少比較兩個真正可行的選項，點出一個關鍵風險，再訂一個回頭檢視點。目標不是完全確定，而是做出一個足夠好、可以行動、也能回頭檢視的決定。
Bonus Clips
加碼影片
If you want a quick outside perspective, here are three videos that reinforce this week’s lesson:
如果你想快速聽聽外部觀點，以下三支影片會呼應本週課程的重點：
References
1) Herbert A. Simon (1955). A Behavioral Model of Rational Choice
Helou et al. (2020). Uncertainty in Decision Making in Medicine: A Scoping Review
Kalis, Kaiser, & Mojzisch (2013). Why we should talk about option generation in decision-making research
https://www.zora.uzh.ch/entities/publication/56d892d8-50d1-4aef-bf2d-50f3f96f3056
Gary Klein (2007). Performing a Project Premortem
https://cltr.nl/wp-content/uploads/2020/11/Project-Pre-Mortem-HBR-Gary-Klein.pdf