Nudge Unit team brainstorming with Kit Delgado pointing at a whiteboard Nudge Unit logo The Nudge Unit designs and implements scalable nudges to improve medical decision-making and patient outcomes

Overview

The Penn Medicine Nudge Unit is the world's first behavioral design team embedded within a health system. The Nudge Unit is supported by the Center for Health Care Transformation and Innovation and the Penn Center for Health Incentives and Behavioral Economics.

 

Vision

We work toward a future where the right choice is the easy choice for health.

Mission

Our mission is to design, implement, evaluate, and scale evidence-based, behaviorally informed nudges that steer decisions toward higher-value care, better patient outcomes, enhanced public health, and greater health equity.

Values

Impact at scale. We are an outcomes-focused team and seek high-impact work that improves patient health outcomes. We design for scale and sustainability of behavior change.

Evidence-based interventions. We enable behavior change through rigorous testing and implementation science.

Health equity. We prioritize equitable health care outcomes benefiting diverse groups and underrepresented minority populations. 

Collaboration. We collaborate with experts and the community to design interventions through bottom-up change. 

Teamwork. We work together as a team to foster open dialogue and trust.

History of the Nudge Unit

The Penn Medicine Nudge Unit was launched in 2016. The team began with two people and, within three years, grew to more than 20. From 2016 to 2021, the Penn Medicine Nudge Unit worked on more than 100 projects, including more than 25 randomized trials resulting in over 75 publications in leading medical journals such as NEJM, JAMA, Nature, and PNAS.

In 2018, the team launched an inaugural Nudges in Health Care Symposium to bring together health systems interested in using nudges or developing nudge units to improve health care. The first two symposia were hosted on Penn's campus and brought together leaders from 30 health systems. In 2021, the symposium took place virtually, and we broadened the audience to include health plans and other organizations working on using nudges to improve health care. The symposium resumed as an in-person gathering in 2023, convening more than 200 people from 50 institutions for an event themed around building behaviorally informed organizations.

Former directors of the Nudge Unit include founding director Mitesh Patel, MD, MBA, and Rinad Beidas, PhD. Kit Delgado, MD, MS, was named director of the Penn Medicine Nudge Unit in September 2022.

Kit brought with him to the role a wealth of experience, a seasoned team of researchers, and an exciting portfolio of work from the Behavioral Science & Analytics for Injury Reduction (BeSAFIR) lab, which he founded in 2017. Integrating the BeSAFIR research into the Nudge Unit portfolio has enabled the team to drive meaningful impact not only among clinicians and patients but also in public health.

Why Nudge?

Human behavior is the final common pathway for most advances in medicine. No matter how effective a medication, protective a vaccine, or beneficial a lifestyle modification is, they can only improve health if clinicians recommend them and patients utilize them.

This is where nudges come in. A nudge is a change in the way information is presented, or choices are framed that is designed to prompt, guide, or motivate good decision-making. A well-designed nudge will make the “right” choice the easy choice without restricting choice.

Project Phases

Projects at the Nudge Unit move through five phases.

Contextual inquiry and data analysis

We gather insights through stakeholder interviews and shadowing to understand inefficiencies and gaps. Additionally, we leverage large datasets to yield important insights about the problems we seek to solve.

Design

We co-design nudges in partnership with care teams, health system leadership, and patients.

Implementation

We implement interventions pragmatically and measurably to inform larger-scale implementation.

Evaluation

We conduct rigorous evaluations of the intended and unintended impact of interventions.

Scale and dissemination

When an intervention is successful, we work with health system leadership to scale the solution and employ strategies from implementation science to promote uptake by clinicians and patients to maximize impact and ensure sustainment. We also share our findings through peer-reviewed publications, social media, and events to benefit other health systems.

Key Project Domains

Nudges to care teams

The design of practice environments heavily influences medical decision-making. We design and implement nudges that improve workflow and steer decision-making toward evidence-based care.

Nudges to patients

Daily health behaviors significantly impact long-term patient outcomes. We design and implement nudges that lead to significant and sustained change in patient engagement and behavior.

Nudges for public health

We design and implement interventions to reduce the public health burden of injury caused by epidemics such as distracted or impaired driving, opioid addiction, and gun violence.

Participate

Attend our symposium

We host an annual symposium to share insights and lessons learned from implementing nudges in health care and build collaborations across health systems. The next Nudges in Health Care Symposium will be held in Philadelphia on September 26–27, 2024.

Publications See more

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