How triage can help to make decisions

We all know the harsh reality of having to make decisions on how to spend such resources as our time and focus.

Last week I co-wrote an article with Ben Preston for The Conversation on climate adaptation and triage.

Triage as a concept emerged in World War I and is:

“a process of prioritizing actions when the need is greater than the supply of resources”.

Triage is mostly used in the field of medicine in trying to sort out which cases are the most urgent, who cannot be helped, and which patients will have a positive outcome with the treatment.

The concept itself is somewhat controversial but it does allow something: admitting when we cannot save something and focusing on our efforts where we can.

While our article looked at triage mostly in the context of climate adaptation, the concept has interesting angles for leadership, and personal development.

 

Protect what you value the most

The idea of triage suggests that you should protect what you value the most.

We recently had a great discussion around this in WonderWomen where we each reflected on how we all have recently made decisions that have supported our vision where we want to go and what we want to achieve.

Being clear on your goals and vision is fundamental because if you do not have guideposts aligning your path, how are you going to know what to protect the most?

Part of triage is evaluation of assets and their value, and then making cost-effective decisions which actions can deliver the most value for money.

Yet, it is not always possible to choose the most cost-effective option because emotions and values are always embedded in every process.

In fact, decision-making is often much more about emotions: the person we want to be, the company we want to create, the society we want to live in.

As Seth Godin notes, it is these emotions that marketing for example targets, finding ways to create tension that only goes away if we buy into what we are missing or want to achieve.

I find this often a constant battle when making decisions and in the end it very much comes down to my values and goals, and what I believe aligns with those.

In a recent episode of Harvard Ideabiz (Use your money to buy happier time), the presenters discussed the relationship between money and happiness, and how we should focus on using money to buy time; to outsource those time-intensive activities we dislike doing.

It made me think further about trade-offs and how we really do need to make decisions that align; that time, as a resource, is so precious that we really need to be very careful what we spend it on and think about alternative ways to enable us to focus on what matters to us.

The questions then we should be asking from ourselves are also what we cannot change in our lives, what we can, and which activities overall will give us the best result.

 

Triaging at a whole other level 

The book I am reading at the moment is very much about triaging and how to make tough decisions with finite resources.

Ben Rhodes’ book “The World as it is” dwells into the some of the most controversial and difficult decision-making processes that took place during the Obama administration.

Ben Rhodes was President Obama’s deputy national security advisor for strategic communications and speechwriting.

Even though I have only started reading the book, it is already one of my favourites.

But what I am struck already by is the immense responsibility that is carried by words, and how these words reflect the decisions that have already been made.

Yet, the very process of dividing scarce resources where the need is much greater not just within one country but across the world is mind boggling: how actions and decisions in faraway countries have massive impacts on people’s lives thousands of kilometres away.

What I find particularly interesting is how people’s own values, beliefs and emotions play into those political decisions, and how high-level decisions get made.

 

Climate adaptation and triage

In the article we suggest three broad categories of decision contexts that can help in determining where we should look in investing our time and efforts:

Impacts that can be avoided or managed with minimal or no interventions. This category means for example identifying activities that don’t necessarily need much intervention but can continue functioning despite adverse effects.

Impacts that are probably unavoidable despite all best efforts. For example, as ice sheets are melting, the living environments of polar bears will change, no matter what we do.

Impacts for which practical and effective actions can be taken to reduce risk. Investing in managing water more effectively, improving emergency service capacity and testing new more efficient agricultural methods are all decisions that are likely to make a difference and reduce risks also in the future.

Out of these categories, category number 2 stands out least for me as the hardest one: how do you know which outcomes are truly unavoidable?

So what are some of the strategies that governments and people could take in making decisions on how to prioritise?

Invest in valuing assets that are at risk. Understanding the value of different assets at your disposal can help in making estimations as to which assets are most valuable. Non-economic assets, e.g. cultural resources are obviously much more difficult to value but this also comes down to society’s attitude to risk.

Identify which strategies have the best potential to reduce risk. Having a better understanding of the array of strategies that are most effective in giving you the outcome you are looking for is crucial.

Invest enough financial, social and political capital to meet the priorities that society has agreed on. This means ensuring that you have the necessary investments in place to even keep making those decisions.

With all of these choices, you should be able to measure and track your progress across to see what is really working, and which choices are making a positive difference.

 

Understanding triage

With climate change, the reality is that adaptation is here to stay and we will not be able to keep going business-as-usual but need to be strategic what we invest and protect and why.

We are also not going to be able to save everything, especially as climate change is a complex phenomenon that exists amongst many other drivers and factors such as loss of biodiversity, changing disease profiles, desertification, and poverty.

Having such conversations early is crucial as climate change impacts are already materialising across the world, as we are seeing for instance with the “unprecedented” fires (Tasmania), heat (January hottest month ever in Australia) and Townsville flooding (as we speak, nearly 20 000 threatened with floods).

Many states in the US are facing their coldest temperatures ever and people are facing such weather conditions that they have no experience of.

What concepts like triage suggests is that resources are finite and we do need to make hard choices, all of which are not going to be nice.

But this doesn’t mean that we ignore emotions.

Understanding what matters to people is essential and a joint conversation about how to proceed forward is highly necessary.

For those in decision-making positions this also means that a broader set of societal values needs to be considered in order to make just decisions.

This means also being clear on what our societies value, how those values are spread across our communities, and what we can and cannot, and are willing (or not) to protect.

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