How Should Clinicians' Performance Be Assessed When Health Care Organizations Implement Behavioral Architecture That Generates Negative Consequences?
How Should Clinicians' Performance Be Assessed When Health Care Organizations Implement Behavioral Architecture That Generates Negative Consequences?
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DOI：
10.1001/amajethics.2020.760
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发表时间：
2020-09-01
影响因子：
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通讯作者：
Richardson S
中科院分区：
文献类型：
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作者：
Richardson S
行为干预已被证明对人类行为有强大的影响，无论是在卫生保健的范围内还是之外。随着组织越来越多地采用行为架构，必须小心考虑其潜在的负面影响。基于证据的方法是最好的，即可能对患者的健康结果产生重大有害影响的干预措施首先进行测试和严格评估，然后再系统地推出。在临床决策支持的情况下，应提供简短和全面的使用说明。医生在使用这些系统时的表现最好在具有类似培训的同行的背景下进行相对测量。错误的责任必须与临床团队成员和系统设计人员共同承担。这篇评论是对编辑部工作人员提出的案例的回应。
Behavioral interventions have been shown to have powerful effects on human behavior both outside of and within the context of health care. As organizations increasingly adopt behavioral architecture, care must be taken to consider its potential negative consequences. An evidenced-based approach is best, whereby interventions that might have a significant deleterious effect on patients’ health outcomes are first tested and rigorously evaluated before being systematically rolled out. In the case of clinical decision support, brief and thorough instructions should be provided for use. Physician performance when using these systems is best measured relatively, in the context of peers with similar training. Responsibility for errors must be shared with clinical team members and system designers. The case to which this commentary is a response was developed by the editorial staff.