Behavioural insights for improving resident decision making Dr Barbara Fasolo Associate Professor Behavioural Science | Head of Behavioural Research Lab b.fasolo@lse.ac.uk A talk prepared for the LGA - 12 March 2019
Nudges for social good - using behavioural insights in local government Thanks to Grace Abel & Umar Taj What's she like?

We cannot change, or *improve*, residents' decisions unless we know their decision mindware (how, and why they decide, or not) 

## Human "Decision Mind-Ware" Is Made Of 2 Systems Designed To See The Waitress Smiling, First. System 1

SYSTEM 2
… slow … deliberate .. Reads all information
… balancing losses 
and gains) …remembers deep, long term goals Aware of biases

## What'S The Difference Between Nudging Behaviour Vs Decision?

"Behaviour" 

- *normally* a **binary** action ("I recycle 
or not") 
- **well-known** but not appealing 
(e.g. I know recycling means using a recycling sack or bank, but my habit is not to recycle). 
- Nudging behaviour is about 
breaking habits, or creating new.
creating informed decision-making 
and educating 'conversations' (I 
chose X because...)

"Decision" (choice)

- **many possible** options (often more 
than 2 ("I choose a payment method to pay for rent arrears")
- some options are new and need to 
be discovered by new information
- Nudging decisions is also about 
The fundamental conflict for all of us who help others decide better How we wish How others others to decide decide Most decision helpers are optimistic Citizens choose by System 1
But we offer choice for System 2
Decision helpers need to be realistic  
offer choice architecture for System 1
Boyce, Dixon, Fasolo and Reutskaja (2010)
offer training For System 2
Fasolo & Taj 2019
Case: Helping to choose a high-quality hospital for elective surgery What do you think residents care most about when choosing a hospital online?

## Hospital Choice Was Offered For System 2

365!

We are not We are not overloaded by primed by the choice, have the We are not afraid postcode, time and or stressed by the discount distance resources to and choose by compare all 365 
quality hospitals We can understand numbers, invert scales, combine conflicting statistics information, map indicators to our preferences, scroll down…

## Which Choice Architecture Could…

Improve transparency, Increase # 
informed choice residents choosing  

## The 3 Stage Project (For Your Later Reference)

Before nudging a decision, structure it!

Create "Choice Menus":

- 2-5 Options (e.g. hospitals) - 2-3 Clusters of Criteria 
- First the most important that is 
forgotten 
- Last the one that people 
overweigh/think most about
- - Easy labels+checks + numbers
Before implementing a choice architecture:
Consider Decision Mindware, Design Choice (Not information) 
Architectures for System 1
Test them before choosing the one to implement (here, just 4)

## 1. Best First, Sort By Quality

Best Quality is First Active Choice Required 
2. Opt-out Default (Highlight the best overall on all the criteria and set as opt-out default)
Same Scorecard as Sort-by-Quality Best is highlighted preselected
© Dr Barbara Fasolo

## 3. Sort By Distance, Best In The 'Hotspot' 4. Preference Articulation (List All Objectives That Are Relevant And Ask To Rank Them By Own Preferences)

…No Hospital is excellent across all indicators… You will need to make trade-offs…
The first indicator tells you how good the quality is… 
When did most residents choose the highest quality hospital?

Best First?

Opt Out Default?

Hotspot?

Preference Articulation?

## When Were Residents Making Most Informed Choices?

With opt-out default When preferences are asked

## Going Back To Your Decision, Can You…

1. Present your residents a simple menu/scorecard 
laying out 2-5 options available?
2. Highlight the option recommended? 3. Include the do-nothing/no-decide option (as 
choosing not to choose is a choice!)?
4. Include a checklist of objectives? 5. Ask to interact and rate these objectives by 
importance?
Thank you, and keep in touch:
b.fasolo@lse.ac.uk