The Nudge Unit is the world's first behavioral design team embedded within a health system. We leverage insights from behavioral science to design, implement, evaluate, and disseminate scalable nudges to steer decision-making toward high-value care, improve patient outcomes, enhance public health, and increase health equity.
The Nudge Unit is supported by the Center for Health Care Transformation and Innovation and the Penn Center for Health Incentives and Behavioral Economics.
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.
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.
We co-design nudges in partnership with care teams, health system leadership, and patients.
We implement interventions pragmatically and measurably to inform larger-scale implementation.
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
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.
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.
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.
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.
We host an annual symposium to share insights and lessons learned from implementing nudges in health care and build collaborations across health systems.