Effective decision-making in public health organizations: reference to the COVID-19 pandemic.

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The role of public health organizations during the COVID-19 pandemic was crucial. These groups acted to slow the spread of infection through the implementation of initiatives, policies, research and more. However, the rapidly changing and uncertain climate of the pandemic resulted in suboptimal processes and decision-making within these organizations. These already complex organizations and networks of people became even more nuanced. Thus, organizational decision-making processes must be improved upon based on previous experiences and lessons learnt. With minimal peer-reviewed literature available, resources for effective organizational decision-making in these organizations are scarce. This served as the impetus for this review. To conduct this literature review, both peer-reviewed and grey literature were incorporated to better understand effective organizational decision-making practices for public health organizations. Recommendations found in the literature review were identified, coded and themed to provide a novel decision-making framework to be used by public health executives. Nine key themes of effective organizational decision-making were identified, including utilize decision-making tools, define the problem and acknowledge an imminent decision, establish decision rights, outline a clear escalation path, create a supportive organizational culture, set decision objectives and goals, and evaluate decision alternatives. These findings in conjunction with existing decision-making models were used to create a seven-step effective decision-making framework for public health organizations. The review and analysis of effective organizational decision-making practices is instructive. Public health executives and decision-makers should incorporate the themes identified and employ the proposed decision-making framework to encourage improved decision-making practices.