Associate medical director for population health and clinical assistant professor in the Department of Medicine at the University of Washington in Seattle.
Hospitalist at the University of Washington in Seattle.
AMA J Ethics. 2020 Sep 1;22(9):E802-807. doi: 10.1001/amajethics.2020.802.
Diffusion of responsibility describes how individuals can underperform in circumstances of shared accountability. While not well studied in health care settings, this phenomenon is an unintended consequence of the health care sector's complexity and fragmentation. This article considers 3 ways in which monetary and nonmonetary incentives can mitigate negative consequences of diffusion of responsibility. First, incentives should be finite and focused. Second, health care organizations can incentivize both individual and team performance. Third, organizations can use peer comparison feedback to amplify effective incentivizing strategies.
责任扩散描述了个人在共同承担责任的情况下如何表现不佳。虽然在医疗保健环境中尚未得到充分研究，但这种现象是医疗保健部门复杂性和碎片化的意外后果。本文考虑了三种通过金钱和非金钱激励来减轻责任扩散负面影响的方法。首先，激励措施应该是有限和有针对性的。其次，医疗机构可以激励个人和团队的绩效。第三，组织可以使用同伴比较反馈来放大有效的激励策略。
