Enhancing Healthcare Field Decision-Making Process through Accounting Tools: Findings from the Surgical Field

Healthcare decision making process is a cognitive process included a choice between option as categories and diagnosis; its complexity is due to the involvement of more peoples and the gap between information availability and necessity. It could be affected by several factors including cognitive shortcut of decision makers. To identify these biases of decision-making process and improve its quality Kahneman identified a tool: the checklist. This study aims to analyse firstly the clinical decision process of orthopaedic surgeons, secondly it aims to understand if and how the more information availability derived by the use of an accounting tool (Time Driven Activity based Costing) can modify the decision-making process. Both goals regarding the decision making process about management of follow-up of patient undergoing a knee and hip arthroplasty surgery. To achieve its goals semi-structured interviews with three orthopaedic surgeons from three different working contexts were conducted. Several biases affected the decision-making process of orthopaedic surgeons choosing follow-up path of their patients; in particular, physicians are mainly influenced by consolidated practice and by the decisions of other departments or opinion leaders. The information derived using an accounting tool might be helpful to improve or modify decision process, although further empirical studies are required to test the feasibility and utility of the tool. This study fosters the debate between practitioners and scholars about the use of tools to improve quality decision process in healthcare sector.