title: Systematic biases in group decision-making: implications for patient safety.
abstract: Key decisions in modern health care systems are often made by groups of people rather than lone individuals. However, group decision-making can be imperfect and result in organizational and clinical errors which may harm patients-a fact highlighted graphically in recent (and historical) health scandals and inquiries such as the recent report by Sir Robert Francis into the serious failures in patient care and safety at Mid Staffordshire Hospitals NHS Trust in the English NHS. In this article, we draw on theories from organization studies and decision science to explore the ways in which patient safety may be undermined or threatened in health care contexts as a result of four systematic biases arising from group decision-making: 'groupthink', 'social loafing', 'group polarization' and 'escalation of commitment'. For each group bias, we describe its antecedents, illustrate how it can impair group decisions with regard to patient safety, outline a range of possible remedial organizational strategies that can be used to attenuate the potential for adverse consequences and look forward at the emerging research agenda in this important but hitherto neglected area of patient safety research.
authors.affiliation: Health Services Management Centre, University of Birmingham, Park House, 40 Edgbaston Park Rd, Birmingham B15 2RT, UK.
authors.forename: Russell
authors.initials: R
authors.lastname: Mannion
authors.affiliation: Department of Health Sciences, University of York, Area 4, Seebohm Rowntree Building, York YO10 5DD, UK.
authors.forename: Carl
authors.initials: C
authors.lastname: Thompson
mesh_terms: D003657:Decision Making; D006126:Group Processes; D006801:Humans; D061214:Patient Safety; D011287:Prejudice; D011787:Quality of Health Care; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom
keywords: group decision-making; patient safety; quality; teams