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Posted: January 11th, 2025

Decision Making and Framing Perspectives

Overview

The notion of framing something is to focus on a moment in time, a scene, or a set of ideas. It can involve deliberate use of intellectual skills or less conscious skills within a sense of perception. The skill and depth used in appraising an event can assist in understanding what might be taking place well beyond the limited knowledge of those who are involved in only part of the event itself.

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Learning

Objectives

At the completion of this module, you should be able to:

  • Define framing
  • Discuss the various viewpoints on framing
  • Explain Bolman and Deals four frames of reference
  • Identify the use of frames of reference.

Framing

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Framing The notion of framing something is to focus on a moment in time, a scene or a set of ideas. It can involve deliberate use of intellectual skills or less conscious skills within a sense of perception. The skill and depth used in appraising an event can assist in understanding what might be taking place well beyond the limited knowledge of those who are involved in only part of the event itself.

 

Frames originate as a result of two aspects:

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  1. Peoples nature:
    • The experiences that nurture us
    • Natural (genetic)
    • Learned experience: Revolve around the nature/nurture influence on how we see the world and its events.
  2. Contrived frames of reference:
    • Deliberately learned and used as a way of more consciously trying to interpret events.

While there are many contrived frames of reference, the work of Bolman and Deal 1993 is one of the most well know pieces of work. They constructed four frames of reference which enables a deeper understanding of organisations. The four frames are discussed as followed:

Structural Frame

The structural frame addresses fundamental questions of organisations:

  • How, where and why responsibilities are assigned
  • What connections and relationships are explicit
  • Details about the mission and aims of the organisation, and the specific ways and means designed to help the organisation achieve its goals
  • Every organisation develops a design, and a set of mechanisms to cope with its environment.

Businesses, governments, and public or private associations all have structure and organisation as a visible frame for their operational philosophy and processes. The structural frame is based on a scientific principle, and on the work of industrial psychologists like Frederick W. Taylor, or sociologists like Max Weber. This frame is also associated with the notion of rationality and the sense that any problem can be solved by any group of people if it is simply organised into the most appropriate structural frame.

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Structural Frame - Assumptions

Organisations exist primarily to accomplish established goals. Structure can be designed and implemented to fit its particular set of circumstances, for example, goals, strategies, environment, technology, and people.

 

Organisations work best when environmental turbulence and personal preferences are constrained by norms of rationality as structure ensures people focus on getting the job done. Coordination and control are essential to effectiveness and is achieved through authority, rules, policies, standard operating procedures, information systems, meetings, etc. Organisational problems originate from inappropriate structures or inadequate systems and can be resolved through restructuring or developing new systems.

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Structural assumptions and frames are reflected in organisational charts which spell out relationships between departments and people who inhabit various “boxes”. Structure usually contains a carefully crafted set of tasks within each sector of the organisation, along with the procedure and protocols used to accomplish the mission. The structural frame is ordered and rational by nature.

  Political Frame

While the structural frame is ordered and rational it lives within an environment. This structured organisation is, in the end, overtaken by the implicit, informal, machinations of office politics, of the exercise of power that works outside the walls of the bureaucracy. This can be illustrated with the phenomenon of the water-cooler or tea room - the meeting place where people talk over what is really going on, and decide how work will or will not get done.

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Organisations are coalitions composed of varied individuals and interest groups - hierarchical levels, departments, professional groups, etc. There are continual differences among individuals and groups in their values, preferences, beliefs and perceptions of reality. Such differences change slowly, if at all.

 

Important decisions in organisations involve the allocation of scarce resources. Due to scarce resources and differences, conflict is central to organisational dynamics, and power is the most important resource. Organisational goals and decisions emerge from bargaining, negotiation, and jockeying for position among members of different coalitions.

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The complex nature of the conflict and tension between and among parts of an organisation ensures that the structure is not viewed in the same way. The leader, even with a structure of advisors and officers, a budget and other resources, may not be able to achieve as much success as they might wish, despite having legitimate power. Others are able to utilise other forms of power, including public opinion and political influence to achieve what they might want, which could be contrary to what the leader desires.

Human Relations Frame

Organisations are formed to meet certain objectives for their members such as:

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  • Workers in a business
  • Students in a university
  • Members of a community club.

An organisation provides the setting where participants gain access to training, education, labour, or resources. There is an implicit, if not explicit, connection between an organisation and the people who belong to it. It has the potential to bring some good to its members and the potential to "use" and even abuse its members.

Human Relations Frame - Assumptions

Organisations exist to serve human needs. Organisations and people need each other as organisations need ideas and energy, while people need salaries and work opportunities.

 

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When the fit between the individual and the organisation is poor, one or both will suffer. Individuals will either be exploited, or will seek to exploit the organisations, or both. A good fit between the individual and the organisation benefits both where human beings find meaningful and satisfying work, and organisations get the human talent and energy that they need.

Symbolic Frame

Organisational environments are often volatile, uncertain, complex, and ambiguous. Symbolic frame is based on a set of things embedded in the organisational culture - rituals, protocols, manners, symbols and even myths, enable a vision beyond tangible elements to find out what really might be important. What is most important about any event is not what happened, but what it means.

 

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The same event can have different meanings because of the way individuals interpret their experiences. Many significant events and processes in organisations are ambiguous or uncertain; it is often difficult or impossible to know what happened, why it happened, or what will happen next. The greater the ambiguity and uncertainty, the harder it is to use rational approaches to analysis, problem solving, and decision making.

 

Faced with uncertainty and ambiguity, human beings create symbols to:

  • Resolve confusion.
  • Increase predictability.
  • Provide direction.

Events may remain illogical, random, fluid, and meaningless, but human symbols make them seem otherwise.

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Many organisational events and processes are important more for what they express than for what they produce: they are secular myths, rituals, ceremonies, and sagas that help people find meaning and order in their lives.

 

The symbolic frame looks at events:

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  • What people do.
    How they form and organise themselves.
  • How they govern.
  • How they reward and punish.

It gauges the importance and significance of the symbols, rituals, customs, practices, and traditions of an organisation and tries to discern what that means.

(Bolman and Deal 1993)

Framing

People frame what they see from their own unique set of experiences, tendencies, and interests. This will, by their very nature, also bring bias. The ability to frame is an essential tool of management. Framing provides insight into the entire meaning of a subject and enables us to make sense of it, to judge its character and significance.

 

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Framing the subject is to choose one particular meaning (or set of meanings) over another. We manage meaning when we assert that our interpretations should be taken as real over other possible interpretations. (Fairhurst, 1996)

Attitudes

People are inclined to view their own attitudes favourably and those of a rival or competitor in a less favourable way. The situations in which people find themselves also affect what they do. For example, we most often believe that our “home” athletic team plays fairly and competitively, while our opponent's players are disposed to play “dirty”.

Problems and Making Sense

Problems do not present themselves to managers and leaders as a given. They need to be constructed from the materials of problematic situations which are puzzling, troubling, and uncertain. There is a need to convert a problematic situation to a problem, and we must make sense of an uncertain situation that initially makes no sense. (Weick, 1995)

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Sense Making

Sense making can take time. It arises out of:

  • An accumulation of barely perceptible items
  • Of plausible speculations
  • On information gathered from sources not part of the current situation
  • On contradictory issues of reputation associated with a respected profession.

Sense making is the task of the leader to interpret or translate this complex of information, to unravel the ball of twine and to make sense of the situation. Scientists, in studying the confusing deaths of African males in the 1980’s, ultimately made sense of what they were seeing, finally identifying the Ebola virus and the symptoms of AIDS. Their sense making provided a new frame of reference for identifying the medical mystery.

Summary

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A person’s way of observing a situation, interpreting and acting is the personal frame of reference. Time and ethics are natural frames of reference, which are not exempt from bias. Gaining situational awareness (external and internal to the organisation) is a critical ability of strategic leaders. The use of frames of reference is a powerful management tool to focus and gain insight to effectively address problems. There are four frames of reference: structural, political, human resources and symbolic frames of reference.

 

Applying all the frames to the analysis of a certain situation should lead to the best outcome in strategic decision making, however, people usually have a natural inclination for the use of a particular frame over others. Additionally, in certain situations, some frames may have more relevance than others. The strategic leader must be able to discern and apply the most appropriate frame of reference in the decision making processes.

Module 8: Clinical and Patient Decision Making

  Overview

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In this module we will discuss the multidimensional and complex nature of clinical decision making. Health professionals are required to make decisions with multiple variables and individuals involved. Clinical decisions, and therefore health outcomes for patients, could be improved involving patients and teams of health professionals in the decision making process.

Quality decision making is an essential component of good clinical practice and quality health care. To improve decision making in health care settings, a broad perspective is required. Evidence-based practice must be integrated with factors such as the individual’s decision making attributes and the influence of external context on the decision making process.

The process of making a decision can be detailed in a series of steps.  These steps are often committed to models of decision-making (Gil-Herrera, 2013; Wilson, 2013) and always starts with the need for as much information as possible in order to analyse this and culminate in a resolution.  This resolution may be the generation of several possible alternatives.

This topic relates to the processes that are used to generate alternatives for the issue being addressed and the rationale selection of the most appropriate of these decisions for implementation.

Learning Objectives

At the completion of this module, you should be able to:

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  • Overview the philosophical and theoretical foundations to judgement and decision making.
  • Understand how clinical judgement and decision making relate to clinicians and patients.
  • Explore the different perspectives and imperatives of clinical and patient decision making in the health context.

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