Patients, Protocols, and Prosocial Behavior: Rule Breaking in Frontline Health Care

Rules are essential components of organizations, especially given their foundational role in inducing organizationally preferred behavior and reducing behavioral variability among its members. Despite the existence and prevalence of these centrally important tools, rule deviation occurs. This study...

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Bibliographic Details
Published inAmerican review of public administration Vol. 50; no. 1; pp. 45 - 61
Main Authors Borry, Erin L., Henderson, Alexander C.
Format Journal Article
LanguageEnglish
Published Los Angeles, CA SAGE Publications 01.01.2020
SAGE PUBLICATIONS, INC
Subjects
Behavior
Bureaucracy
Decision making
Deviation
Emergency medical services
Emergency services
Patients
Personality
Public services
Rules
emergency medical services
prosocial behavior
street-level bureaucracy
rule breaking
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Summary:Rules are essential components of organizations, especially given their foundational role in inducing organizationally preferred behavior and reducing behavioral variability among its members. Despite the existence and prevalence of these centrally important tools, rule deviation occurs. This study proposes to understand the ways in which emergency medical service (EMS) professionals break rules for prosocial purposes—to help patients. In particular, this research seeks to understand how specific organizational and personal attributes influence rule-breaking tendencies. Results indicate that aspects of ethical climate are significantly related to prosocial rule-breaking (PSRB) tendencies, whereas empathy is not. In addition, this study finds that other characteristics, such as a conformist personality, risk taking, expertise, and experience on the job influence PSRB. These findings contribute to the literature on rule deviation and EMS practices and shed light on the complexity of decision making in frontline public services.
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ISSN:0275-0740
1552-3357
DOI:10.1177/0275074019862680