The “BIG” ask: Using behavioural insights to register organ donors and save lives

Ministries across the B.C. government are responding to the Digital Plan’s calls to action with new services, products and practices. We’re excited to showcase the teams working to build an inclusive, accessible and connected BC Public Service.

In today’s post, the BC Behavioural Insights Group shares how they applied service design principles to the process of gathering organ donor registrations in Service BC centres.

Hundreds of people in our province rely on the generosity of organ donors every year. However, connecting recipients with those life-saving donations depends on successfully registering organ donors. The waitlist for organ donations in B.C. can reach into the hundreds and not everyone is connected to a donation in time.

In British Columbia, people can register their decisions regarding organ donation either online or in person at Service BC centres. These decisions can be “yes” or “no”; either way, registering is useful because it helps the registrant’s loved ones follow their wishes.

With registration numbers down since the COVID-19 pandemic began, the BC Behavioural Insights Group (BC BIG) partnered with Service BC and BC Transplant to design and test strategies for boosting organ donation decision registrations in Service BC centres across the province.

Applying behavioural insights to organ donation

Part of any behavioural insights project is to identify barriers that may stop people from taking an action — in this case, registering their organ donation decision.

Some of the barriers were:

• People not knowing how to register their organ donation decision
• Despite having positive views of organ donation, people not getting around to registering because of the time or consideration needed
• Customer service representatives in Service BC centres feeling uncomfortable bringing it up with people, as it is a sensitive topic

Based on these barriers, the team designed an intervention that focused on two aspects: messaging and timing.

Messaging

The team tested two key messages on posters displayed in Service BC centres.

Message 1 addressed the intention-action gap. Even people who intend to donate can forget to follow through on their decision to register. Research shows 90% of people in B.C. support organ donation, but only 25% are registered as organ donors! The first poster highlighted this fact with the goal of drawing people’s attention to whether they have followed through on their intention.

Message 2 focused on social and emotional connection. This message was written to inspire self-reflection.

Timing

The team experimented with Service BC customer service representatives handing out organ donation forms when people arrived.

• People are less likely to make important, personal decisions when pressured for time or distracted with other tasks
• Customer service representatives’ discomfort in asking people about organ donation is relieved by providing material about this sensitive issue to people early in their visit

BC BIG collaborated with all project partners to determine how marketing materials should be displayed in the eight participating Service BC centres. They designed a staggered approach. The new tactics were introduced at two offices to start, with two more offices added each month until the end of the six-month pilot. This allowed the team to track, modify and adapt the strategy while ensuring changes did not interfere with normal operations.

Measuring the impact of the pilot

The team calculated the percentage of customers who completed and submitted organ donation registration forms during their visits to the Service BC centres.

Through statistical analysis, the team was able to attribute a 5x increase in organ donation decisions to the poster with message 1 (“90% of people…”) and a 3x increase in donation decision registrations as a result of handing out the forms at the welcome desk.

BIG plans for the future

Through understanding insights about human behaviour and leveraging existing research from B.C., Ontario and the U.K., the project team successfully boosted organ donation registrations by 5x during the pilot. The project also yielded useful information about the quantifiable impact BC Transplant’s messages had their outcome of interest – organ donation registrations. This data has helped BC Transplant make evidence-based decisions in their marketing and communications efforts since.

Although a rise in registration rates is a positive step, more work is needed to identify and remove other barriers in the organ donation process. BC BIG looks forward to supporting future life-saving efforts.

Every day, more people are registering to be organ donors. You can do your part by registering to be an organ donor or by verifying you are already registered.