Showing people how their behaviour compares to their peers is a commonly used method to improve behaviour. But after the burnouts of the pandemic, it wasn’t clear whether this was still a good idea for highly stressed healthcare workers.
Recent research published in JAMA Network Open throws new light onto the relationship between peer comparison and job satisfaction among clinicians, challenging prior findings that such feedback increases job dissatisfaction and burnout.
Researchers found that behavioural interventions aimed at improving performance can be designed to protect clinician job satisfaction and improve quality of care. To avoid negative impact, the research team discovered it is important for clinicians to have control over the behaviour being evaluated or encouraged, such as ordering tests or whether to prescribe medication.
“Our research demonstrates that peer comparison aimed at improving performance can be designed in a manner that safeguards clinician job satisfaction,” said lead author Dr Jason Doctor at the University of Southern California. “Prior findings to the contrary don’t appear tied to peer comparison, but rather clinicians being measured for things they don’t have full control over.”
The Importance of Methodology in Peer Comparison
Performance feedback using peer comparison is a widely used approach in healthcare to change behaviour. Study authors emphasize the importance of methodology when conducting peer comparison intervention. They note the present study gave clinicians full agency over the outcome, kept performance private, did not restrict the number of top performers, and was successful in improving clinician behaviour without lowering job satisfaction.
Doctor and his team assessed data from their previously published research that assessed the impact of three interventions – Suggested Alternatives, Accountable Justification, and Peer Comparison – to reduce inappropriate antibiotic prescribing. In this study, they focused on on peer comparison, where clinicians received an email informing them of their ranking, from highest to lowest, for inappropriate prescriptions compared to their peers.
The findings contribute to the ongoing dialogue surrounding healthcare quality improvement and clinician well-being.
“By better understanding behavioural interventions and developing more effective strategies, healthcare organisations can foster a sense of ownership and agency, leading to improved job satisfaction and decreased burnout rates,” said Doctor.
