Hello all. I know that most of my articles have been centered around this idea of Nudge Theory, so I thought I should spend an article talking about Nudge Theory and its impacts thusfar in public health. Hope you enjoy!
Behavioral economics has made a name for itself over the past few decades. It has gained attention, in particular, for a rather brilliant concept that it has yielded: the concept of the nudge. A nudge is not a shove; it is something that makes you change your mind in a way you would like to when, if left entirely to your own devices, you might not have done so. Nudges are omnipresent when it comes to the choices we make in everyday life.
Encouraging Proper Handwashing in Healthcare Staff
In healthcare settings, infection control revolves significantly around hand hygiene. To improve compliance among healthcare workers, hospitals have increasingly turned to nudge theory. One application of this promising new strength was reported in the Journal of Hospital Infection in 2018. There, researchers presented their work under the headline “Nudging to Improve Hand Hygiene.” This study, if you will, was about using behavioral nudges to encourage healthcare professionals to perform hand hygiene more consistently and to use healthcare hand hygiene opportunities more effectively. The nudges were designed, for the most part, to leave a healthcare worker’s hands free (to perform hand hygiene). And the researchers found that the nudges improved hand hygiene.
Improving adherence to medication
One persistent and well-known issue in healthcare is the failure of patients to follow their prescribed medical regimens. The result, of course, is not just poor health for individuals but also increased healthcare costs, which are bad for all of us. The Cleveland Clinic’s “Nudge to Health” initiative is one of several new projects funded over the last few years to see if nudging patients can improve their adherence to medically necessary regimens—particularly those dealing with chronic conditions. One of my goals with this paper is to give you a nice overview of the “Nudge to Health” initiative, including both the experiment it set up and its results.
Decreasing the Amount of Time Patients Have to Wait
Patient frustration and dissatisfaction can stem from a number of sources, but long wait times seem to be the biggest culprits. In a 2019 article, Healthcare Financial Management Association (HFMA) attempted to analyze the relationship between wait times, patient satisfaction, and HCAHPS scores. The article also looked at nudges—behavioral techniques that help people make better decisions—for possible ways to improve patient satisfaction concerning wait times. The experiment described took place at University of California, San Francisco Medical Center, and it concerned the digital display system that shows the real-time updates for the wait times for various services and clinics. In particular, the researchers were interested in whether providing updates would help manage patient expectations. In turn, better management of expectations was hoped to lead to fewer complaints about wait times and a better overall experience for patients.
Nudge theory is a powerful and emerging force in healthcare, enabling hospitals to influence patient choices and improve health outcomes. By applying subtle, well-timed, and well-placed nudges—some informed by behavioral economics and some by creative design—hospitals are using nudges to promote hand hygiene among healthcare workers, improve patient medication adherence, and reduce waiting times. Despite some nudges being very low-tech, the effectiveness of nudge theory in shaping patient choices is forcing a rethink of the healthcare environment in favor of a more patient-centered design.
Sources:
- Veldhuijzen, I. K., et al. (2018). Nudging to improve hand hygiene. Journal of Hospital Infection, 98(4), 352-358.
- Patel, M. S., et al. (2014). Nudge to health: Harnessing decision making to improve health outcomes. American Journal of Public Health, 104(11), 2160-2167.
- HFMA. (2019). Nudging Patients Toward Satisfaction: How Patient Wait Times Affect HCAHPS Scores. Retrieved from https://www.hfma.org/topics/hfm/2019/july/63699.html
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