#uncertainty aversion

Jack Duddy, Behavioural Strategist at Ogilvy Change

I took this screen shot a few months ago when I was on Viagogo buying tickets. Within this one screenshot I can personally identify a combination of nudges being applied to make me follow through with my purchase -  so let’s start by listing them off from the top of the screen. “These tickets will no longer be reserved in…”  - Scarcity and Loss Aversion– having a countdown clock massively increases the urgency for people to stick with their commitment to buying the tickets and follow through with the purchase through Scarcity of Time. Also, emphasising that I will no longer have the tickets triggers me to be loss-aversive and retain MY tickets.

“These are the last tickets available at this price” – Scarcity again – Showing that I have reserved some of the last tickets at this price subconsciously increases my value of the tickets.

“1 other person have waited to view these tickets” – Social Norms – I barely understand this sentence and one other person isn’t that many, however by simply inferring that there are others looking at the same tickets makes me want to snatch the tickets from them. Interestingly, I would say this nudge was the most influential in making me carry through with my purchase.

“You’re awesome Jack” – This is not so much a “Nudge” but a completely true statement... however I would say they nudge here using Ego Inflation which is then followed through with language such as “Our warm welcome” which is using Affective language that evokes an emotion of a warm, fuzzy feeling.

“Our tickets are 100% guaranteed” – Uncertainty Aversion/ Regret Aversion - This use of language is important in this context. When buying tickets a huge fear is that they won’t turn up on time after months of waiting for the big day. This simple collection of sentences calms these fears and makes me believe that Viagogo are to be trusted with my precious tickets.

These are the Nudges I can identify within this page, if you have any challenges or addition please leave a comment. Now I will also say that this was just ONE page of the entire ticket-buying process. Each page was littered with Nudges such as countdown clocks, watching eyes and pricing architecture. This made buying these tickets an incredibly anxiety-inducing thing to do – as is the trend for many ticket websites and Hotel booking sites (I’m looking at you Booking.com). However, the reward for completing the process and achieving the purchase almost makes the process worth it. Not to mention the relief of not having nudges machine-gunned in your general direction. Opening this topic up for discussion, do you like the direction of having multiple nudges baked into each layer of a booking experience or not? 95% of readers leave a comment and share this blog…   …sorry.

By Chloe Hutchings-Hay, Analyst at Ogilvy Consulting’s Behavioural Science Practice

When people think of disasters, the common image is one of social breakdown, panic and irrational behaviour. It has also been suggested that people become hostile and take aggressive action towards others when faced with a disaster. This is in line with the ideas of Le Bon who suggested that submergence in the crowd leads to the loss of the conscious personality, with instincts for personal survival overriding socialized responses. In his view, due to mass contagion these reactions can spread quickly through a social group and create mass panic.

What is panic?

People who have been involved with disasters or watched them unfold often describe panic breaking out. However, the term panic refers to: irrational, groundless or hysterical flight that is carried out with complete disregard for others. Therefore, most often people are mistaking ‘fear’, which is perfectly rational, with ‘panic’, which would imply their behaviour was completely out of line with the risk posed. It is appropriate to experience fear in a crisis, and fleeing from a disaster is often the most rational course of action: this is not indicative of panic.

In reality, incidences of panic are very rare. It has been suggested that panic only occurs in very specific circumstances. Research has suggested that for a true instance of panic, the following conditions must be present at once: 1) the victim perceives that they are trapped in a confined space, 2) escape routes seem to be quickly closing, 3) flight seems to be the only way to survive and 4) no-one is available to help (Auf der Heide, 2004).

What do people actually do in disasters?

Many real-world cases suggest that, rather than acting selfishly, people tend to pull together both during and after disasters, displaying remarkable collective resilience. For example, analysis of behaviour during the London 7/7 bombings showed that there were only three accounts of people acting selfishly. Many more people described seeing altruistic behaviours. Although people were using the language of panic to describe what went on, their actual behaviour did not match the definition of panic (Drury et al., 2009).

Similarly, analysis from survivors of 9/11 found that almost everyone reported that the evacuation process to be calm and orderly, with evacuees making room for emergency responders to pass them by (Connell, 2001).

Another common belief is that disasters are usually accompanied by increases in antisocial activity, such as looting, traffic violations, and violence. Even when looting is not actually observed, this is often attributed to extraordinary security measures and the fact that such behaviour is inherently uncommon is overlooked. In actual fact, the amount of donated goods far exceeds that which could be looted in disasters (Heide, 2004). The remarkable collective resilience shown by communities in the wake of a disaster often goes unnoticed by media outlets (Drury et al. 2009).

Why is the notion of widespread panic a problem?

 The widespread belief that the inevitable response to disasters is panic is massively problematic for several reasons, including:

1.     Officials may hesitate to issue accurate warnings because they are afraid of causing panic, meaning that people are only informed of imminent risk at the last possible moment. This is problematic not only because it actually endangers people more, but also because people may begin to trust those relaying disaster messages less.

2.     It prevents effective disaster preparation. People may become afraid that even the suggestion of preparing for a disaster would lead to panic ensuing, when actually disaster preparedness is absolutely vital. A particularly striking example comes from the difference in evacuation speed of the World Trade Centre from the 1993 bombings to the 2001 attacks. In 1993, the average exit time was 15 minutes (from Tower 1) and 35 minutes  (from Tower 2). If the same evacuation speeds had been replicated in 2001, many more people would have died. A key difference between the two attacks was that after 1993 regular fire drills were carried out in the World Trade Centre and people were therefore more prepared.

3.     The fear of widespread looting may prevent evacuation, despite this actually being an uncommon reaction.

4.     The notion of panic can be used to deflect blame away from responsible parties. For example, the Hillsborough disaster was initially blamed upon a mass panic reaction. It later came to light that there was gross negligence on the part of the crowd controllers and the stadium design had contributed to the disaster, rather than it being the fault of those in the crowd themselves.

5.     The focus upon panic masks a potentially larger risk, the risk of mass apathy. There are often significant delays in evacuating groups in impending emergencies, and some people choose not to evacuate at all. One of the key problems is that people tend to feel overly relaxed in the face of emergencies, in striking contrast to the idea that they will be massively panicked! If people do not feel that their life is in jeopardy, they likely will not evacuate. Disaster communication needs to be serious enough to convince people of the need to evacuate. Disaster communication needs also to consider other barriers to evacuation, such as illiteracy, mobility issues and lack of economic resources.

How should we actually communicate before and during disasters?

There is often mistrust for public information, and people often cross-check information with others and online to validate it. Therefore risk communication needs to be both widespread and consistent so that people know the key information and they trust it. The information relayed should be easy to understand and the key points should be repeated.

The person relaying the message should be proportionate to the risk posed, for example the Minister of State for Health would be appropriate for a national health outbreak, but less so for a local one. They should also be honest and truthful if they do not know the scale of a threat. Most crises have an element of uncertainty; the person communicating should admit uncertainty and say what they are doing to overcome it.

As we know that panic in response to disasters is actually uncommon, risk communicators should be preparing the public for the worst possible outcome if necessary. People who are feeling afraid can find it calming to prepare because it lets them feel in control, however many people will not be afraid and may even have stopped listening altogether. Every time officials repeat practical advice, more people take it (Sandman, 2009).

Finally, we need to minimize the language of panic. Instead of focusing on the possibility of panic we need to think about the risk of people doing nothing to prepare. Government disaster planners are researching the best ways to prompt people out of inaction and the impact of different forms of crisis communication (see https://bit.ly/2F71xij). Behavioural science no doubt plays a critical role in understanding risk perception and in designing successful crisis communication.

 References

Connell, R. (2001). Collective behavior in the September 11, 2001 evacuation of the World Trade Center (Preliminary Paper# 313). Newark, DE: University of Delaware Disaster Research Center.

Drury, J., Cocking, C., & Reicher, S. (2009). The Nature of Collective Resilience: Survivor Reactions to the 2005 London Bombings. International Journal of Mass Emergencies and Disasters, 27(1), 66-95.

Heide, E. A. (2004). Common misconceptions about disasters: Panic, the disaster syndrome, and looting. The first 72 hours: A community approach to disaster preparedness, 337.

Rubin GJ et al. Psychological and behavioural reactions to the 7 July London bombings. A cross-sectional survey of a representative sample of Londoners. BMJ, 2005; 331(7517): 60-11

Sandman, P. M. (2009). The Swine Flue Crisis: The Government Is Preparing for the Worst While Hoping for the Best – It Needs to Tell the Public to Do the Same Thing. Retrieved from: http://www.psandman.com/col/swineflu1.htm

Jordan Buck, Behavioural Strategist at Ogilvy Change

In hospitals, tiny errors can have major consequences. Especially in the operating theatre, time is often of the essence, and the stakes are high. However, budget pressures are often intense meaning large-scale expensive solutions to problems and challenges – such as more staff, further training or better machines – are often not possible.

This means that smaller ‘nudges’ – inexpensive changes with potentially large behavioural consequences – can often be an ideal solution. A number of these behavioural science-inspired techniques have already been trialled and implemented in hospitals worldwide, improving outcomes and saving lives.

Names on caps

One recent intervention has been a movement to encourage surgical staff to display their name and job role on their cap. As communication errors are the most common cause of adverse events in healthcare (Walker, Reshamwalla & Wilson, 2012), these caps can play a vital role in helping to decrease confusion in the operating theatre, making it easier to identify colleagues in the midst of an emergency.

As we all have a limited amount of mental bandwidth available to us at any one time, the more cognitive effort we put into one task – such as trying to remember someone’s name, or figure out who’s under that face mask – the less we have remaining for other tasks. By allowing non-critical processes (here, identifying and naming colleagues) to operate via quick System 1 processing, the name caps allow for conscious processing and attention to be focused where it is most necessary, on the surgery at hand. 

The caps have also reportedly helped to decrease the bystander effect. Previously, ambiguity over who has been asked to do what has led to significant delays, as each individual has assumed that someone else is responsible. But with everyone’s names prominently displayed, any ambiguity over who is talking to who can be significantly reduced.  

Checklists

As simple as they may be, checklists have also been shown to make a substantial difference to patient safety. That’s because, although everyone may be perfectly capable of doing what they need to do, the repetitive and methodical nature of many healthcare procedures can mean that tiny but crucial steps can sometimes be accidentally overlooked.

Just as writing a to-do list can ensure we remember all the things we want to get done tomorrow, so following a checklist can ensure that we complete every necessary step every single time. Simple things, like making sure each new member of staff double checks with the patient whether they are focusing on the correct limb, help to ensure that the correct process is always followed with no exceptions – so no one wakes up to find they’ve had the wrong leg amputated.

“By standardizing performance, checklists reduce reliance on memory and thus reduce errors of omission. This is particularly applicable to healthcare as processes become more complex, staff become busier, and handovers and shift working become more common.”

- Walker, Reshamwalla & Wilson, 2012

Sanitiser salience

As well as hospital staff, hospital visitors also play a large role in patient safety. Hospital-acquired infections, often brought in by visiting friends and family, are a significant problem with around 6% of hospital patients in England acquiring some form of infection during their stay.

One simple intervention aiming to tackle this was trialled in Denmark, which involved simply changing the location and appearance of the hospital hand sanitisers to nudge visitors into using them. Firstly, hand sanitisers were moved out of the wards and into the main corridor, where visitors were guaranteed to walk past. Next, red signs were added to them, saying “Here, we use hand disinfectant in order to protect your relative" – leveraging social norms (this is the accepted behaviour or ‘done thing’ here), personalisation (‘your relative’), and salience (a large red sign).

These tiny changes led to a huge increase in hand hygiene compliance: the percentage of visitors using sanitiser rose from 3% to 20% when the hand sanitiser was moved into the corridor, and again to 67% when the sign was also added (Aarestrup, Moesgaard & Schuldt-Jensen). 

Perhaps introducing more cost-effective measures like these could be a promising way forward in alleviating some of the pressure on our healthcare systems, working with the resources we have but making sure our hospitals are at the very least ‘behaviourally optimised’ – using inexpensive behavioural hacks that can ultimately save lives.

Aarestrup, S. C., Moesgaard, F. & Schuldt-Jensen, J. Nudging Hospital Visitors’ Hand Hygiene Compliance. iNudgeyou