Career advice

The right rewards

Rewards are an effective way of persuading people to change their behaviour.

Rewards are an effective way of persuading people to change their behaviour. Financial and other incentives can be used in patient care to increase motivation and support the attainment of care goals.

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They can boost uptake of preventive health practices such as screenings and vaccinations. When used for quitting smoking or weight loss, they can reduce the high cost of long-term disease management.

Incentives largely result in positive outcomes, although they can also have a negative impact on patient care. It will help to strike a balance to achieve care goals with the following pointers:

The goal should be agreed by patient and caregiver. Including patients in care planning supports autonomy. However, while goals should be formulated with the patient, it is important to keep the end goal of the entire care plan in mind. Ensure that care is patient-centred and consistent with evidence-based practice.

Just as no single treatment is appropriate for all patients, incentives need to be tailored. When offering incentives, make sure they are suited to the patient’s physical, mental and social conditions. Matching patient care plans to the appropriate incentives increases the likelihood that the treatment plan and goal will be adopted successfully. In addition, once incentives are offered, the necessary treatment or resource for achieving the goal must be readily available to patients.

When used in the right environments, incentives can have positive outcomes. Studies show that incentives, particularly financial ones, are effective for low-income and high-risk populations. There is further evidence that they can bridge disparities in patient care within public health environments. The best have short-term, achievable and measurable goals.

Incentives are a great tool to promote and cement positive health behaviours, but there is a dark side. Unrealistic goals or overlarge incentives can lead to under-reporting of symptoms, as well as failures and inefficiencies in care.

Setting unachievable goals or offering insignificant incentives can make patients feel cynical or lose interest. It is important that when identifying and implementing incentives, you also consider whether there is a possibility an incentive will be abused or a goal will be circumvented.

Incentives may be needed for patient care because certain barriers can keep patients from making positive changes. These can be significant enough to prevent them acquiring appropriate care. Such barriers include lack of financial resources to pay for care and lack of access to appropriate patient care resources. Incentives, therefore, must be designed to address and overcome these barriers.

In nursing care, the use of incentives needs to be patient-driven and goal-oriented to have the most positive impact on patients’ behaviour. Be aware of the needs of your specific patient population before deciding on incentives. Ideally they should be short-term and measurable so patients gain the most benefits.

Maintaining an adequate balance between patient goals and associated incentives will lead to positive patient care outcomes and, in the longer term, help reduce healthcare costs.

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