Steps for Deploying Nudges in Health Care.

Step	Roles of a Nudge Unit
Identify opportunities	Work with members across the health system to identify suboptimal care. Investigate the decision-making process to pinpoint a specific change that could shift behavior. Work with leadership and the information technology team to evaluate intervention feasibility. Prioritize opportunities with higher likelihood of success that have potential to be scaled.
Measure outcomes	Understand the current state and potential impact of an intervention using measurable outcomes, including process measures (e.g., prescribing patterns, referral rates), utilization (e.g., imaging, emergency-department visits), and patient outcomes (e.g., length of stay, readmissions, mortality).
Pragmatically implement	Determine potential approaches for introducing a change in choice architecture within the health care delivery system. Assess the effects on clinician workflow. Consider possible unintended consequences and ways of addressing them. Explore feasibility of scaling the intervention more broadly if successful.
Align stakeholders	Obtain buy-in from health system and clinical department leadership as well as support from clinicians at the frontlines of care. Consider competing priorities and solicit feedback on intervention design.
Compare effectiveness	Use evidence-based approaches to design interventions in a testable manner, such as through randomized trials or quasi-experimental approaches. Evaluate immediate changes from the intervention, sustained effects, and unintended consequences.
Translate findings to scale	Leverage findings to further optimize nudges and expand them more broadly throughout the health system. Disseminate knowledge on best practices through multiple avenues, including publication.