A new publication in JAMA Internal Medicine explores whether subtle electronic nudges can prompt intensive care unit (ICU) clinicians to improve communication with seriously ill patients and their families.
Led by researchers at Penn’s Palliative and Advanced Illness Research (PAIR) Center, including DBEI faculty members Scott D. Halpern, MD, PhD, and Michael Harhay, PhD, the pragmatic trial tested two electronic health record (EHR) interventions designed to encourage clinicians to discuss prognosis and offer comfort-focused care options to patients with chronic serious illness on mechanical ventilation.
Although the interventions did not reduce hospital length of stay—the study’s primary outcome—the nudge encouraging comfort-focused treatment discussions was associated with increased hospice discharges and earlier comfort-care orders. These results suggest that such behavioral nudges can meaningfully influence end-of-life care processes, even when broader outcomes remain unchanged.