Peer Decisions May Hold Greater Impact on Us Than We Perceive
In high-stakes healthcare settings like maternity wards and operating rooms, peer influence can significantly impact medical decisions, such as choosing between Caesarean section (C-section) and vaginal delivery. A recent study conducted by Jillian Chown and Carlos Inoue in Brazil sheds light on the key workplace factors driving this influence.
### Key Workplace Factors Driving Peer Influence:
1. **Leader Support and Staff Influence**: Leader support plays a crucial role in fostering a positive work environment where peer influence can be constructive. When team members feel supported and influential, they are more likely to collaborate and share input on complex decisions, including mode of delivery.
2. **Work Pressure and Psychological Safety**: High work pressure negatively affects patient outcomes and staff satisfaction. By reducing work pressure and fostering psychological safety, peer influence is more likely to lead to open discussions and peer input.
3. **Peer-to-Peer Recognition**: Recognizing colleagues’ expertise and contributions builds trust and a culture of appreciation, encouraging the sharing of different clinical perspectives and supporting teamwork.
4. **Role Clarity and Scope of Practice**: Clear boundaries and respect for professional roles influence peer interactions and decision-making authority. In the context of C-sections, input from nurses and mid-level providers can influence timing or approach.
5. **Supportive Care Practices (e.g., Doula Care)**: Additional support roles like doulas have been associated with higher rates of vaginal birth after cesarean and reduced preterm births, suggesting that influence from these care team members impacts delivery decisions favouring less invasive methods.
### Impact on Medical Decisions like C-section vs. Vaginal Delivery:
1. **Collaborative Decision-Making**: In environments where staff have influence and are supported, there is more meaningful peer discussion about delivery methods, potentially leading to more judicious use of C-sections versus vaginal delivery.
2. **Reduction of Unnecessary Interventions**: Peer influence supported by recognition and reduced work pressure can encourage evidence-based practices that avoid unnecessary C-sections, promoting vaginal births when safe and appropriate.
3. **Enhanced Patient Satisfaction and Outcomes**: When peer influence fosters teamwork and shared decision-making, patient satisfaction improves, and complications such as preterm births and emergency interventions may be reduced.
The study, which analysed data covering more than five million births performed by 16,500 physicians across 915 public hospitals in Brazil, found that doctors were more likely to perform C-sections when working a shift with a colleague who had a higher practice style score (i.e., was more likely to perform a C-section than their model would predict). The effect of peer influence was particularly strong when the best course of action was uncertain.
By harnessing the power of peer influence, organisations can shape behaviours, improve decision-making, and drive better outcomes. In maternity wards, hospital administrators could encourage positive peer influence by assigning doctors with a preference for vaginal deliveries to training new physicians or shifts where they will have the greatest influence.
The public health system in Brazil, which has one of the highest rates of caesarean births in the world, with 56% of births delivered via C-section, could benefit significantly from implementing strategies that promote collaborative decision-making and reduce unnecessary interventions.
- In the realm of education-and-self-development and personal-growth, fostering a supportive work environment that values peer-to-peer recognition can encourage learning through meaningful collaboration, contributing to constructive peer influence and improved decision-making in high-stakes healthcare settings.
- Furthermore, by promoting a culture that supports both personal-growth and learning, organizations can potentially reduce unnecessary interventions like Caesarean sections, leading to enhanced patient satisfaction and outcomes, and helping to align practices with evidence-based recommendations.
