%0 Journal Article
%T Reimagining the Humble but Mighty Pen: Quality Measurement and Naturalistic Decision Making
%A Eric C. Schneider
%J Journal of Cognitive Engineering and Decision Making
%D 2018
%R 10.1177/1555343418784372
%X Much of the health system¡¯s avoidable spending may be driven by doctors¡¯ decision making. Past studies demonstrated potentially consequential and costly inconsistencies between the actual decisions that clinicians make in daily practice and optimal evidence-based decisions. This commentary examines the ¡°best practices regimen¡± through the lens of the quality measurement movement. £¿Although quality measures have proliferated via public reporting and pay-for-performance programs, evidence for their impact on quality of care is scant; the cost of care has continued to rise; and the environment for clinical decisions may not have improved. Naturalistic decision making offers a compelling alternative conceptual frame for quality measurement. An alternative quality measurement system could build on insights from naturalistic decision making to optimize doctors¡¯ and patients¡¯ joint decisions, improve patients¡¯ health outcomes, and perhaps slow the growth of health care spending in the future
%K health care delivery
%K decision making
%K naturalistic decision making
%U https://journals.sagepub.com/doi/full/10.1177/1555343418784372