Decision Science
A decision analysis software program helped the Spokane Regional Health District in Spokane County, Washington create a budget that was more transparent, revealing how and why decisions were made.
Public health organizations usually create budgets through an informal process; agencies generally grant funding to programs that appear needy. The administrators in charge of creating budgets rely on information from competing program directors; budgets do not necessarily reflect the best interest of the entire agency. Decision analysis transforms budgeting into a scientific process; it breaks a problem into discrete parts that an organization can analyze.
This article explains the key features of decision analysis and describes how the Spokane Regional Health District implemented a decision analysis software program. The Spokane Regional Health District governs almost 50 public health programs. The district created a decision-making framework, or a hierarchy chart, from numerous goals and sub-goals. The health district’s management team initially created a broad set of budget goals. They met weekly for six months to decide what goals they would enter into the software program.
Key Findings:
- Spokane Regional Health District eliminated funding to four programs.
- Based on data generated by the decision analysis software, the Spokane Regional Health District conducted a review of 15 of its programs.
- The health district discontinued its clinical services program, transferring the activities to community-based Federally Qualified Health Centers.
A public health agency must distribute its limited resources among competing programs. A budget usually has a limited role within a public health organization. This article describes how decision analysis helped the Spokane Regional Health District take a more scientific approach to budgeting.
April Issue of Health Affairs Focuses on Patient Safety and Health Care Quality
- 1. The Ongoing Quality Improvement Journey
- 2. A Road Map for Improving the Performance of Performance Measures
- 3. The Trade-Off Among Quality, Quantity, and Cost
- 4. 'Global Trigger Tool' Shows that Adverse Events in Hospitals May be Ten Times Greater Than Previously Measured
- 5. Preventing Bloodstream Infections
- 6. Measuring the Performance of Individual Physicians by Collecting Data from Multiple Health Plans
- 7. Measuring Health Care Performance Now, Not Tomorrow
- 8. Despite Improved Quality of Care in the Veterans Affairs Health System, Racial Disparity Persists for Important Clinical Outcomes
- 9. The Importance of Transitional Care in Achieving Health Reform
- 10. An Early Status Report on the Beacon Communities' Plans for Transformation Via Health Information Technology
- 11. A Comparative Study of 11 Local Health Department Organizational Networks
- 12. Public Health Performance
- 13. A Self-Assessment Process for Accreditation Preparedness
- 14. Public Health Delivery Systems
- 15. A Shot in the Rear, Not a Shot in the Dark
- 16. What Predicts Local Public Health Agency Performance Improvement?
- 17. Growth of a Scientific Community of Practice
- 18. Evolution of Coauthorship in Public Health Services and Systems Research
- 19. Resources that May Matter
- 20. Evidence Links Increases in Public Health Spending to Declines in Preventable Deaths
- 21. Public Health Financial Management Competencies
- 22. Decision Science
- 23. Public Health Financial Management Needs
- 24. Data-Driven Management Strategies in Public Health Collaboratives
- 25. Using Geographic Information Systems to Match Local Health Needs with Public Health Services and Programs
- 26. Public Health Systems and Services Research
- 27. Mapping the Multidisciplinary Field of Public Health Services and Systems Research