Using Cognitive Mapping and Qualitative System Dynamics to Support Decision Making in Intellectual Disability Care

Provider organizations specializing in supporting people with intellectual disabilities (ID) are under pressure because of public policy reforms, changes in society, and increased customer expectations. The combination of all these factors makes long-term decision making a challenge for the managers of such organizations. The majority of research examining decision making in ID service organizations has commonly studied the issue from the perspective of healthcare providers. The authors contend that the degree of success of ID support providers depends on their ability to appreciate the views and interests of service receivers and frontline workers, the most important components in the system. Having a comprehensive picture of key stakeholders' overall perspectives on problem situations can enhance managers' understanding of the behavior of a complex system they manage. The authors suggest that the combination of qualitative system dynamics modeling and cognitive mapping techniques can facilitate collaborative representation of the stakeholders' views in a way that can support decision making in complex healthcare systems. The authors illustrate the application of this combined method through a case study in one ID supports provider in the Netherlands and demonstrated the possibilities of using structured stakeholders' perspectives related to flexible pool schedule shifts, one of the key resource allocation dilemmas in the organization, for organizational decision making.