In the National Adult Inpatient Experience Survey, two questions pertaining to patients' understanding of their medication side effects and condition management received low scores. This suggests that patients being discharged from the hospital don’t always understand the treatment they receive and how to manage their condition at home. Our Chief Behavioural Scientist worked with the Health Quality and Safety Commission and three partnering District Health Boards to investigate these low scoring questions and co-designed three nudges to improve patient experience in hospitals.
Make it SOCIAL: Encourage patients to ask questions as the new norm
Make it EASY: Hospital staff can easily share relevant information
Make it TIMELY: Patients can absorb information in a relatively healthy state
Make it SOCIAL: Patients receive relevant information via a friendly,personalised follow-up call
MAKE IT EASY: Make information cognitively easier to process
MAKE IT ATTRACTIVE: Draw attention to the right information
For each of the three hospitals, a phone survey was conducted by a local pharmacist with 20 patients. We used the EAST framework to evaluate the impact of the interventions across the four parameters:
1. Easy – Did the nudge make it easy to get information?
2. Attractive – Was the format useful for you?
3. Social – Would you recommend the nudge for others?
4. Timely – Was the timing of the intervention useful for you?
The ‘Home Safe Checklist’ was pre-piloted at a hospital ward in Waikato DHB, the ‘Follow-up call’ was put on hold at Blenheim Hospital in Nelson-Marlborough DHB since the call durations were longer than anticipated and the ‘Optimised Discharge Summary’ is now ready for testing at Northland DHB following IT changes.
Make it EASY – 9 out of 12 positive responses from the phone survey.
Make it ATTRACTIVE – 8 out of 10 positive responses from the phone survey.
Make it SOCIAL – 10 out of 11 positive responses from the phone survey.
Make it TIMELY – 9 out of 11 positive responses from phone survey
Overall the ‘Home Safe Checklist’ nudge excelled in the qualitative evaluation across all four measurement parameters. We have recommended a large scale pilot to rigorously measure the impact this has on improving patient experience in hospitals.
Vishal George is the Chief Behavioural Scientist at Behavioural by Design and hosts the Wellington and Auckland Behavioural Economics Network.