The garbage can and willful choice decision-making models act as strategies for healthcare leaders to assess problems and deliver solutions. The concepts focus on a rational view (willful choice) and realistic view (garbage can) of decision making amongst organizational chaos. While both exist to support the decision process, there are stark differences in methodology. The purpose of this essay is to define both models in a healthcare context with a focus on the pros and cons of each along with an analysis of the core similarities and differences.
Willful or rational choice is a decision-making model that emphasizes order and an analytical approach in determining solutions. It is a systematic method that utilizes knowledge, measures, and environmental analysis to produce the most ideal solution. Each decision is analyzed based on its possible consequences with an emphasis on short and long-term solutions. These processes require ample amounts of information, time, and people. While quality solutions are produced, the willful choice model does not allow for flexibility regarding environmental changes such as technology and healthcare policy. Internal changes including turnover also negatively impact the rational decision process. Given the pros and cons of rational decision-making, the healthcare environment may not be the best fit for the willful choice model.
Within healthcare organizations, chaos is prevalent with little time to thoroughly analyze a problem and produce