Implementation from a habit perspective

Abstract

In their efforts to provide evidence-based care healthcare professionals prescribe, provide advice, conduct examinations, perform surgical procedures, and engage in a range of clinical behaviours. Their clinical actions are characteristically performed repeatedlysometimes multiple times per day -in the same physical locations with the same colleagues and patients, under constant time pressure and competing demands. This repetition under pressure in a stable setting provides ideal circumstances for creating contingencies between physical and social cues and clinical actions. Healthcare professional behaviour provides an ideal setting in which to advance theory, methods and interventions to better understand habit formation and habit reversal. Contemporary theoretical and methodological development in the psychology of habit has begun to be applied to understand and promote the formation, breaking, and replacement of habitual behaviour in healthcare professionals. This chapter highlights key theoretical approaches, methods, and intervention techniques that have been applied to conceptualize, measure, develop, and break habit and automaticity in healthcare professionals. These insights have the potential to synergistically contribute novel perspectives to the wider habit literature.

Conceptualising Four Categories of Behaviours: Implications for Implementation Strategies to Achieve Behaviour Change

“…Strategies like education and training could be tailored depending on what might be most needed (66). In Square B (individual-level influence/non-conscious mode) one should consider observing health care practitioners' individual habits that may hinder adoption of the new guideline recommendations (12). For example, nurses may automatically manage patients' temperature with paracetamol at the wrong temperature threshold (63).…”

“…Strategies may also be based on incorrect assumptions that current practise relies on conscious cognitive processing although the behaviours may be largely habitual. The extent to which the behaviours depend on conscious or non-conscious cognitive processes is not commonly addressed in implementation science (10)(11)(12); e.g., whether the use of a certain evidence-based intervention is characterised by careful deliberation or if the use is more automatically enacted.…”