Choice architecture


It’s very easy to focus on the negative aspects of one’s experiences. It’s the path of least resistance – it actually takes more effort to refocus one’s attention onto the vast amount of excellence which occurs everyday. Much has been written on the reasons for this negativity bias, and I won’t explain it here. And I do concede, very willingly, that much of our progress in healthcare (and in society in general) has resulted from our ability to notice the negatives; so I would never say that we should stop doing it.

But there are also many benefits from noticing the good. When you notice what is working, you learn something new. When you show appreciation or gratitude for the good, you improve your mood and that of those around you. Unfortunately, it takes effort to use the lens of positivity. Can we make it easier to access our positive worldview?

I contend that we can use choice architecture to make it easier for us and our colleagues to CHOOSE to see the positive aspects of their work. Providing easy access to an excellence reporting system, and making sure that the system works (i.e. positive feedback is forwarded in a timely manner) are key steps to making it easier to recognise excellence and to show appreciation. Linking the excellence reporting system with the adverse incident reporting system also provides an easy opportunity for staff to balance their observations of their workplace.

We know from 4 years of experience (and thousands of excellence reports) that this does not reduce the amount of adverse incident reports- it simply adds more intelligence to the reported data.  It also  makes it easier for staff to chose to notice what is working, and to show appreciation to colleagues.