Do National Health Guidelines increase coordination level among physicians? An experimental investigation

Coordination is the key to the success of any organization such as the healthcare sector, where higher level of coordination result in greater promptness and quality of care and lower mortality rates. In a framed field experiment, we assess the level of coordination among healthcare providers and monitor whether common practices are adopted in a metropolitan hospital in Italy, by using the Krupka-Weber norm elicitation task. Upon being provided with three clinical vignettes, physicians have been asked to evaluate the appropriateness of each of the possible actions to match the modal judgement. Afterwards, physicians may ask for information on the actions corresponding to national guidelines and eventually change decisions. Data show that the average frequency of coordination across the experiment is 52% and that coordination increases when physicians often exchange opinions and share positive feedbacks with colleagues. Only 23% of participants changed their appropriateness judgment, after realizing they were in contrast with guidelines. In addition, the presence of a leader in the ward facilitates coordination. Finally, the more physicians consult scientific sources, the more willing to accept guidelines suggestions have been. Since guidelines knowledge significantly increases the coordination between physicians, hospitals should implement effective programs to spread guidelines contents.