Decision Record
One versioned, signed document for one dated decision.
Every service-line, practice, or capital decision answers the same questions on its way to “yes” — objectives, options, trade-offs, sensitivity, dissent, reversal. In most hospitals those steps happen anyway: in a spreadsheet, a slide, a hallway conversation. You can't skip the steps. You can only skip writing them down.
A Decision Record brings the economics and the governance of one strategic decision into the same object. This is what it contains.
- 01
Decision question
One dated decision, one owner, one deadline. The record exists because a real vote is coming.
- 02
Decision criteria
What the decision is optimizing for, and the constraints it must respect — agreed before the results exist, so the numbers answer the question instead of choosing it.
- 03
Options
The realistic alternatives, compared on the same axes: demand, reimbursement, workforce, capital, and downside.
- 04
Evidence and assumptions
Every material claim carries its origin — observed in your data, drawn from external sources, produced by a model, or assumed. Unresolved items are marked as such rather than filled with a guess.
- 05
Sensitivity
Which assumptions actually move the answer, and by how much. The board sees where the recommendation is robust and where it is not.
- 06
Recommendation and dissent
Why the recommended option wins — and where material disagreement remains, recorded rather than smoothed over.
- 07
Reopen conditions
The specific conditions that would make the organization revisit the decision, with checkpoints.
- 08
Approval trail
Who approved what, on which version. The record is versioned and signed, and it stays that way.
How an engagement runs
1
Intake
A guided conversation with leadership defines the decision, its deadline, the criteria, and the data package.
2
Data package
A decision-specific set of operational and financial extracts, named in advance. Missing inputs are classified before work starts — some can be substituted, some narrow the scope, some block a recommendation. No EHR integration is required to start.
3
Economics and sensitivity
The engine runs the options through structural models — demand, patient choice, economics — with explicit assumptions. Same inputs, same numbers.
4
Record
The Decision Record is delivered versioned and signed. Reopen conditions stay attached to it after the vote.
See one built for your decision.
Client records are never published. In a thirty-minute conversation we can walk through the record structure against a decision you actually have to make — and say what it would take.