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Working Collaboratively Toward Effective Decision-making. Frances D. Butterfoss, PhD, MSEd James M. Krieger, MD, MPH Michael P. Rosenthal, MD. Democracy. “It’s not perfect, but it’s the best way for 280 million people to make a decision.”. Process of Building Governance.

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Working collaboratively toward effective decision making

Working Collaboratively Toward Effective Decision-making

Frances D. Butterfoss, PhD, MSEd

James M. Krieger, MD, MPH

Michael P. Rosenthal, MD


“It’s not perfect, but it’s the best way for 280 million people to make a decision.”

Process of building governance
Process of Building Governance

  • Develop mission & goals

  • Integrate ideas from many stakeholders

  • Transition from networking to engaging, involving & empowering partners

  • Qualitative analyses may provide insight into process

Continuum of decision making power
Continuum of Decision-making Power


Coalition develops ➨ Coalition itself

recommendations, but has final decision-

other organization(s) making power

has final say

Wandersman, 1981

Shared formalized decision making in coalitions
Shared & Formalized Decision-making in Coalitions

  • Creates positive coalition environment

  • Ensures that member benefits outweigh costs

  • Encourages pooling of resources

  • Increases member engagement(commitment

    to mission & goals, participation in activities, satisfaction with coalition work)

  • Makes effective assessment & planning more likely

    Butterfoss & Kegler, 2002

Models of decision making in coalitions
Models of Decision-making in Coalitions

  • Steering Committee, coalition chair or lead agency decides

  • Voting or majority rule (2/3 rule)

  • Consensus

  • Combination of models depending on issue

Rapid decision making models
Rapid Decision-making Models

  • Steering Committee (coalition & committee chairs & key at-large organization members)


  • Steering Committee gets input from members via email then decides

  • Staff decides with input from key leaders & organizations

  • Action alert vote is sent via email to members

Allies against asthma decision making models
Allies Against Asthma Decision- making Models




Level of comfort with decision making process
Level of Comfort with Decision-making Process



Power in decision making1
Power in Decision-making

* Significantly associated with:

  • Positive opinion about leadership

  • Agreement with coalition vision

  • Reporting more benefits of participation

  • Higher degrees of support and trust

    * p=< .01

Examples of difficult or controversial decisions
Examples of Difficult or Controversial Decisions

  • Decisions about mission, goals & objectives

    • Transition from asthma campaign to asthma management & research focus

  • Decisions who gets resources & recognition

    • Referring & coordinating requests for patient education & home assessments fairly among partners

  • Decisions about power, prestige & influence

    • Competition for election to coalition office

  • Decisions about funding opportunities/grants

    • Competition for who leads, who shares

Resolving conflict
Resolving Conflict




  • Decision-making in coalitions can be potential source of conflict

  • Decision-making must be managed in standard, fair & timely manner

  • Comfort with decision-making leads to member satisfaction, commitment & participation

  • Coalitions that practice good decision-making are more likely to be effective & sustained