Using the Nudge Theory to Enhance Attending Anesthesiologist Breaks

Area of Science:

• Behavioral Economics
• Healthcare Quality Improvement
• Anesthesiology

Background:

• Human behavior is susceptible to subtle influences, termed
• nudging
• which exploit cognitive biases and habits.
• Effective teamwork in healthcare, particularly in anesthesiology, relies on mutual support, including timely breaks.
• Previous interventions have not fully explored the impact of social norm-based nudges on intraoperative provider behavior.

Purpose of the Study:

• To assess the effectiveness of a norms nudge on improving compliance rates for attending anesthesiologists providing breaks to their colleagues.
• To determine if displaying performance data and social comparisons can modify intraoperative break-giving practices.
• To evaluate the impact of this intervention within a care team model in anesthesiology.

Main Methods:

• A quality improvement study was conducted involving attending anesthesiologists.
• A "norms nudge" intervention was implemented, displaying top performers and individual performance relative to departmental averages.
• Compliance rates for providing morning, lunch, and afternoon breaks were tracked before and after the intervention.

Main Results:

• The norms nudge intervention was associated with a statistically significant increase in break compliance.
• Morning break compliance rose from 75.0% to 78.1% (p = 0.0002).
• Lunch break compliance increased from 83.0% to 86.3% (p < 0.0001), and afternoon break compliance improved from 61.8% to 65.3% (p < 0.0001).

Conclusions:

• Norms nudges can effectively modify intraoperative practices related to provider breaks.
• This intervention offers a low-cost, low-investment method to enhance teamwork and provider well-being in anesthesiology.
• The findings suggest that leveraging social norms is a viable strategy for quality improvement in surgical settings.