Making Better Decisions - Lessons Learned from Jeff Bezos

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Jeff Bezos is one of today’s most successful and visionary entrepreneurs. One of his many strengths is his ability to look out into the future and make some calculated strategic decisions about Amazon’s future. I found his ideas (outlined in the new book, Invent and Wander) about decision making to be pretty compelling. Bezos points out that sometimes people think about all their decisions in the same way when they are not. He divides decisions into two categories. The first category is one-way-door decisions. These are critical decisions that are highly consequential and usually irreversible. To change one’s mind after the fact can lead to disaster. Bezos believes that these decisions should be heavily debated and analyzed from several different vantage points, even when you have a great deal of data. In our healthcare system, some that might fall into this category include:

A merger with another entity
A change in an electronic health record
A leadership reorganization
Closing a unit, program, or service
A leader’s decision to leave an organization
Selection of a new leader for the team
Moving to an ACO model
Buying a physician group

There is a second type of a decision, which Bezos calls a two-way-door decision. These decisions are reversible. If the decision proves to be wrong – you change. Not as much debate is needed with two-way-door decisions because they can be undone. Most daily decisions that we make in nursing would fall into this category.

Bezos has an excellent strategy about how to manage dissent. He believes you will rarely reach full consensus on a decision. With some decisions, it can be challenging to know what the right thing to do really is. When you find yourself in this position, Bezos recommends that you use a disagree and commit approach. As a nurse leader, you would tell your team that robust debate is good, but at the end of the day, a decision needs to be made. Those who don’t agree with the decision are asked to disagree but commit. Each team member agrees to do it this way and commits not to say – I told you so.

Using this decision making strategy has worked well for the Amazon team and is transferrable to healthcare settings. Bezos jokingly says that sometimes he needs to serve as the “chief slowdown officer,” especially with the one-way-door decisions. This is advice worth taking.

Read to Lead

Bezos J. Invent and Wander: The Collected Writings of Jeff Bezos. Harvard Business Review; 2021.

Read Rose Sherman’s book – The Nurse Leader Coach: Become the Boss No One Wants to Leave