The behavioural insights work includes the following:
Development and use of MINDSPACE
The MINDSPACE report sets out nine of the most robust influences on our behaviour. (These are: Messenger, Incentives, Norm, Defaults, Salience, Priming, Affect, Commitments and Ego.) This report helped to support the establishment of the Behavioural Insights Team, at the heart of the UK Government. The MINDSPACE report continues to be used by the Behavioural Insights Team as a framework to aid the application of behavioural science to the policymaking process.
Increasing handwashing rates
To reduce the incidence of Healthcare Associated Infections, simple ways to increase handwashing rates in a surgical intensive care unit were investigated, based on insights from the behavioural literature. We found that the presence of a clear, citrus scent, or a picture of eyes significantly increased hand hygiene rates. This suggests applying behavioural insights can suggest simple ways to change behaviour.
Reducing missed appointments and increasing screening uptake
Missed hospital appointments are a major cause of waste in the health service, and lead to poor use of staff and worse care for patients. While text messages are increasingly used to address this, we are investigating whether different content, based on behavioural theory, can increase their effectiveness. For example, we have found that including the cost of a missed appointment to the health system can increase the effectiveness of the messages.
Following on from this, we are comparing several different reminder text messages for their impact on cervical and breast cancer screening uptake. The effectiveness of redesigned materials on increasing uptake of bowel cancer screening is also being tested. Other research is investigating whether different types of financial incentives can increase attendance at diabetic eye screening.
Reducing prescribing errors
More than one in 15 hospital prescriptions contains some kind of error, usually because the writing is illegible or some information is missing. It is the most frequent cause of avoidable harm to patients in hospital. A revised prescription chart was developed using the MINDSPACE framework, which requires medical staff to circle pre-printed prescription quantities, use colour coding for the length of treatment and print their names in block capitals. From a trial at St Mary’s hospital, published in BMJ Open, this was found to reduce several common prescribing errors.
Understanding and improving self-management behaviours
Work is being conducted to understand determinants of poor medication adherence in different conditions, and to develop interventions to sustainably improve adherence. We are also looking at facilitators and barriers to people with diabetes checking their feet, to detect and treat problems to prevent the formation of ulcers. These insights can then be used to design ways to improve self-management and health outcomes for people with diabetes.
Improving health through design
The Healthcare Innovation Exchange or HELIX is a collaborative centre run by Imperial College London and the Royal College of Art. HELIX applies design thinking to save time, money and ultimately, lives, by combining the expertise of designers, clinicians and researchers to tackle the everyday challenges in healthcare.