Make the right decisions and safeguard your thinking, write Richard Mitchell and Janine Chandler

Decisions are the lifeblood of action, in organisations and for individuals. Without them little gets done. Yet decisions can be complex and we as leaders are never going to get everything right. We can all think of examples where manifestly competent leaders have made an error of judgement. In healthcare, the consequences of these poor decisions can be costly or even fatal.

The authors of this fascinating and instructive book detail primary research on strategic decisions and extensive secondary research in neuroscience and on decision making to offer a realistic road map towards making more powerful, lower risk decisions.

They identify decisions ranging from the Federal reaction to Hurricane Katrina to Boots’ expansion into healthcare in 2004 which were inherently flawed. The evidence concluded at least one of four red flag conditions is present when flawed thinking happens.

The authors suggest these conditions can be negated by four types of safeguard, including governance and monitoring. The book provides a great framework for decision making. None of the ideas are novel but they are combined to form a new practical model. Our only criticism is that it would have been interesting to have examples of decisions made using the framework which proved well made.

Applying the model in this book could prove the most astute cash you have ever spent. If you want to try before you buy, visit

Richard Mitchell is a divisional manager at North West London Hospitals trust and Janine Chandler is a strategic consultant at the Central Office of Information.