“10 Practical Areas for Behavioural Science to Improve Productivity in Health”

“I welcome these innovative proposals to use behavioural science to improve productivity in the health system. Using insights from behavioural science offers a simple way to ensure that more people are treated in our health service, as quickly as is achievable.”

“Many of the suggestions, such as changing the default to day case rather than inpatient where clinically appropriate for certain hospital procedures, offer better value alternatives to existing practices in Ireland, and will be better for both patients and staff.”

“When I established the Taskforce, I said that we are changing and must continue to change how we deliver health services. The suggestions in this discussion paper can increase productivity while maintaining existing clinical standards and creating a better experience for patients and staff.”

“Small, uncomplicated changes informed by behavioural science, like those proposed in this paper, can make a big difference. Many of the proposed changes are low cost and relatively quick to scale up.”

“The newly established Productivity Unit in the HSE will consider the proposals outlined in the paper as it develops its work programme.”

“I want to ensure that my Department works with the HSE to improve productivity and efficiency in the health service. This includes using simple and innovative interventions, informed by behavioural science. Broad adoption of proposals in this discussion paper would help to achieve more productive and better healthcare delivery.”

The 10 practical areas outlined in the paper are:

1. Increase hospital productivity by changing default options, such as changing the default to day case rather than inpatient for certain hospital procedures.

2. Increase hospital productivity by reducing readmissions and average length of stay by using improved discharge templates and additional supports.

3. Increase productivity by reducing did not attends for hospital appointments by using behaviorally informed content (shown to increase patient engagement) in correspondence such as appointment offer letters and text reminders.

4. Increase productivity by growing uptake of online services and improving administrative processes by reducing administrative burden through use of sludge audits.

5. Increase productivity by using behavioural insights to support use of key good practices in elective care such as using low-complexity pathways for low-risk patients, using enhanced recovery practices, and increasing throughput in theatres by measuring, communicating and managing the number of cases per theatre session.

6. Reduce influenza’s influence on demand and supply by increasing flu vaccination uptake with behaviourally informed letters / correspondence for the community, and by using multifaceted approaches for health workers.

7. Reduce unnecessary demand for Emergency Departments and outpatient consultations by using audit and feedback with checklists for GPs and by providing written guidance for patients and parents.

8. Reduce unnecessary antibiotics prescribing in general practice through greater use of behavioural interventions shown to reduce unnecessary prescribing, such as education, communication training, point of care testing, other decision support tools, and delayed prescribing. This will result in both financial and health gains, as reducing unnecessary antibiotic prescribing is central to reducing antimicrobial resistance.

9. Reduce future demands and costs by growing cancer screening through better correspondence by incorporating insights from behavioural science into screening offer letters and processes.