Changing healthcare professionals' non-reflective processes to improve the quality of care

Sebastian Potthoff* (Corresponding Author), Dominika Kwasnicka, Leah Avery, Tracy Finch, Benjamin Gardner, Nelli Hankonen, Derek Johnston, Marie Johnston, Gerjo Kok, Phillippa Lally, Gregory Maniatopoulos, Marta Moreira Marques, Nicola McCleary, Justin Presseau, Tim Rapley, Tom Sanders, Gill Ten Hoor, Luke Vale, Bas Verplanken, Jeremy M Grimshaw

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
6 Downloads (Pure)


Rationale: Translating research evidence into clinical practice to improve care involves healthcare professionals adopting new behaviours and changing or stopping their existing behaviours. However, changing healthcare professional behaviour can be difficult, particularly when it involves changing repetitive, ingrained ways of providing care. There is an increasing focus on understanding healthcare professional behaviour in terms of non-reflective processes, such as
habits and routines, in addition to the more often studied deliberative processes. Theories of habit and routine provide two complementary lenses for understanding healthcare professional behaviour, although to date, each perspective has only been applied in isolation.
Objectives: To combine theories of habit and routine to generate a broader understanding of healthcare professional behaviour and how it might be changed.
Methods: Sixteen experts met for a two-day multidisciplinary workshop on how to advance implementation science by developing greater understanding of non-reflective processes.
Results: From a psychological perspective ‘habit’ is understood as a process that maintains ingrained behaviour through a learned link between contextual cues and behaviours that have become associated with those cues. Theories of habit are useful for understanding the individual’s role in developing and maintaining specific ways of working. Theories of routine add to this perspective by describing how clinical practices are formed, adapted, reinforced and discontinued in and through interactions with colleagues, systems and organisational procedures. We suggest a selection of theory-based strategies to advance understanding of healthcare professionals’ habits and routines and how to change them.
Conclusion: Combining theories of habit and routines has the potential to advance implementation science by providing a fuller understanding of the range of factors, operating at multiple levels of analysis, which can impact on the behaviours of healthcare professionals, and so quality of care provision.
Original languageEnglish
Article number114840
Number of pages10
JournalSocial Science and Medicine
Early online date11 Mar 2022
Publication statusPublished - 1 Apr 2022

Bibliographical note

This research was supported by the Health Foundation Improvement Science Award (grant number: GIFTS ID 7223 awarded to SP). JMG holds a Canada Research Chair in Health Knowledge Transfer and Uptake. DK’s work is carried out within the HOMING program of the Foundation for Polish Science co-financed by the European Union under the European Regional Development Fund; grant number POIR.04.04.00-00-5CF3/18-00; HOMING 5/2018. We would also like to thank Lauren Basey for optimising the design of our included figure.


  • Habits
  • routines
  • dual process models
  • theories of practice
  • healthcare professionals
  • quality improvement
  • implementation science
  • behaviour change


Dive into the research topics of 'Changing healthcare professionals' non-reflective processes to improve the quality of care'. Together they form a unique fingerprint.

Cite this