Pay Crafting: An Intervention to Reduce Ethical Dilemma and Moral Injury in Healthcare

Last registered on April 02, 2024
View Trial History

Pre-Trial

Trial Information

General Information

Title
Pay Crafting: An Intervention to Reduce Ethical Dilemma and Moral Injury in Healthcare
RCT ID
AEARCTR-0013279
Initial registration date
April 01, 2024

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
April 02, 2024, 12:50 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

There is information in this trial unavailable to the public. Use the button below to request access.

Request Information

Primary Investigator

Name
Lambert Zixin Li
Affiliation
Stanford University
Contact Primary Investigator

Other Primary Investigator(s)

Additional Trial Information

Status
In development
Start date
2024-04-02
End date
2024-07-15
Keywords
Behavior, Finance & Microfinance, Firms & Productivity, Health, Labor
Additional Keywords
JEL code(s)
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
I will conduct a RCT to reduce the adverse effect of financialization of healthcare on caregivers' ethical dilemma (e.g., overprescription) and moral injury. Specifically, to reduce these adverse effects of pay for performance, I will examine an intervention entitled "pay crafting." The intervention is the participative management of front-line healthcare workers in setting their own evaluation and pay criteria. We will compare this intervention with pay criteria set by the administrators (based on productivity or patient outcomes), given the same amount of pay.
External Link(s)

Registration Citation

Citation
Li, Lambert Zixin. 2024. "Pay Crafting: An Intervention to Reduce Ethical Dilemma and Moral Injury in Healthcare." AEA RCT Registry. April 02. https://doi.org/10.1257/rct.13279-1.0
Sponsors & Partners
Experimental Details

Interventions

Intervention(s)
Pay crafting intervention: Front-line healthcare workers will be invited to decide on their own evaluation criteria, which were used to determine their bonus pay.
Intervention Start Date
2024-04-10
Intervention End Date
2024-07-10

Primary Outcomes

Primary Outcomes (end points)
Ethical dilemma
Primary Outcomes (explanation)
It will be constructed from behaviors such as overprescription, unnecessary examination, insufficient bedside time, etc. These behaviors will be determined from electronic medical records.

Secondary Outcomes

Secondary Outcomes (end points)
Moral injury
Secondary Outcomes (explanation)
This will be measured by a validated scale in a panel survey.

Experimental Design

Experimental Design
There will be three experimental groups: 1) pay crafting, as discussed above; 2) a group whose evaluation and pay criteria were set by the administrators, based on productivity (which is the status quo); and 3) a group whose evaluation and pay criteria were set by the administrators, based on patient outcomes (e.g., adverse events).
Experimental Design Details
Not available
Randomization Method
Randomization done in office by a computer
Randomization Unit
medical unit/team
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
300 medical units
Sample size: planned number of observations
1800 healthcare workers
Sample size (or number of clusters) by treatment arms
100 medical units per treatment arm
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Stanford University
IRB Approval Date
2022-09-14
IRB Approval Number
65289
Analysis Plan