As nudges—subtle changes to the way options are presented to guide choice—have gained popularity across policy domains in the past 15 years, healthcare systems and researchers have eagerly deployed these light-touch interventions to improve clinical decision-making. However, recent research has identified the limitations of nudges. Although nudges may modestly improve clinical decisions in some contexts, these interventions (particularly nudges implemented as electronic health record alerts) can also backfire and have unintended consequences. Further, emerging research on crowd-out effects suggests that healthcare nudges may direct attention and resources toward the clinical encounter and away from the main structural drivers of poor health outcomes. It is time to move beyond nudges and toward the development of multi-level, structurally focused interventions.

中文翻译：

---

对临床医生指导的推动的严格审查


过去 15 年来，随着“助推”（通过对选项呈现方式的微妙变化来指导选择）在各个​​政策领域越来越受欢迎，医疗保健系统和研究人员急切地采用这些温和的干预措施来改善临床决策。然而，最近的研究发现了助推的局限性。尽管在某些情况下推动可能会适度改善临床决策，但这些干预措施（特别是作为电子健康记录警报实施的推动）也可能适得其反并产生意想不到的后果。此外，关于挤出效应的新兴研究表明，医疗保健推动可能会将注意力和资源转移到临床上，而不是导致不良健康结果的主要结构性驱动因素。现在是超越推动，转向制定多层次、结构性重点干预措施的时候了。