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Related Experiment Videos

Outpatient process quality evaluation and the Hawthorne Effect.

Kenneth Leonard1, Melkiory C Masatu

  • 1Department of Agricultural Economics, University of Maryland, 2200 Symons Hall, College Park, MD 20742, USA. kleonard@arec.umd.edu

Social Science & Medicine (1982)
|August 5, 2006
PubMed
Summary

Clinician behavior changes when observed, impacting healthcare quality. The Hawthorne effect caused a temporary rise in patient-reported quality in Tanzania, which then declined over time.

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Area of Science:

  • Health Services Research
  • Behavioral Economics
  • Medical Sociology

Background:

  • The observer effect, or Hawthorne effect, can influence study participant behavior.
  • Understanding this phenomenon is crucial for accurate healthcare quality assessment.

Purpose of the Study:

  • To investigate the impact of research observation on clinician behavior and healthcare quality.
  • To provide evidence of the Hawthorne effect in a healthcare setting in Tanzania.

Main Methods:

  • Analysis of patient-reported quality of care data in Arusha, Tanzania.
  • Conducting patient interviews before and after the research team's arrival.
  • Quantifying changes in quality based on the timing of patient consultations relative to the research presence.

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Main Results:

  • Patient-reported quality remained stable before the research team's arrival.
  • A significant 13-percentage-point increase in quality was observed immediately upon the research team's arrival.
  • Healthcare quality subsequently declined, nearing pre-arrival levels by the 10th-15th consultations.

Conclusions:

  • The Hawthorne effect demonstrably influences clinician behavior and healthcare quality metrics.
  • Findings have significant implications for designing unbiased quality measurement tools in healthcare.
  • Policy interventions for quality improvement must account for observer effects.