The Nudge Unit designs and implements scalable nudges to improve medical decision-making and patient outcomes
Mission
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 medical decision-making toward higher-value care, improved patient outcomes, and more equitable health care delivery. Consistent throughout our work is a desire to make the right choice the easy choice.
The Nudge Unit is supported by the Center for Health Care Innovation and the Penn Center for Health Incentives and Behavioral Economics.
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 only help if clinicians recommend them and patients engage with them. Successful nudges align decisions and behaviors with long-term health goals, and implementation science promotes their uptake and sustainment at scale.
The goal of a nudge is to improve outcomes without restricting choice. To achieve this, nudges change the way options are presented or the way information is framed. Nudges should be transparent and aligned with the welfare of the person being nudged, with an easy way for people to opt-out if they want to.
Project Phases
Projects at the Nudge Unit move through four phases.
Design
We co-design nudges in partnership with care teams, health system leadership, and patients.
Implementation
We implement interventions in a pragmatic and measurable manner 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
The design of any practice environment heavily influences medical decision-making within it. We aim to 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 interventions that lead to significant and sustained change in patient engagement and daily behaviors.
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. More than 400 people representing over 200 organizations from around the world attended.
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.
Participate
We host an annual symposium to share insights and lessons learned from implementing nudges in health care and build collaborations across health systems.
