A Clinician-Focused Nudging Intervention to Optimize Post-Surgical Prescribing

Inclusion Criteria for Patients: * Aged greater or equal to 18 years * Undergoing specified elective general, gynecologic, orthopedic, and neurological surgeries at VUMC during the specified study periods (days 1-60 for the initial patient group; days 105-164 for the follow-up patient group) * General: laparoscopic or open cholecystectomy, laparoscopic or open appendectomy * Gynecologic: abdominal hysterectomy, laparoscopic/robotic hysterectomy, vaginal hysterectomy, anterior repair/colporrhaphy, posterior repair/colporrhaphy, tension-free vaginal tape procedure, sacrospinous ligament suspension sacrocolpopexy * Orthopedic: total knee arthroplasty, total hip arthroplasty, total shoulder arthroplasty, 1- or 2-level spinal laminectomy (without fusion) * Neurological: 1- or 2-level spinal laminectomy (without fusion) * Provided postoperative opioid prescription (verified in VUMC electronic medical record (EMR) * Able to understand study procedures and participate in the pill count and telephone/electronic interview process in English or Spanish * Able to provide informed consent Exclusion Criteria for Patients: * Opioid prescription filled (per VUMC EMR and patient self report) between 3 months and 7 days prior to surgery * Primary reason for surgery as assessed by chart review is cancer-related * Surgery is a repeat/revision surgery (e.g., revision total knee arthroplasty) * Patient has been inpatient for \>3 days postoperatively prior to receiving post-discharge prescription * Vulnerable populations: current pregnancy, prisoners * Prior participation in the study (e.g., a patient included in the initial patient group will not be recontacted for the follow-up patient group) Inclusion Criteria for Surgeon Participants -General, gynecologic, orthopedic, or neurological surgeon at VUMC during the study period performing any of the surgeries listed below * General: laparoscopic or open cholecystectomy, laparoscopic or open appendectomy * Gynecologic: abdominal hysterectomy, laparoscopic/robotic hysterectomy, vaginal hysterectomy, anterior repair/colporrhaphy, posterior repair/colporrhaphy, tension- free vaginal tape procedure, sacrospinous ligament suspension sacrocolpopexy * Orthopedic: total knee arthroplasty, total hip arthroplasty, total shoulder arthroplasty, 1- or 2-level spinal laminectomy (without fusion) * Neurological: 1- or 2-level spinal laminectomy (without fusion) Exclusion Criteria for Surgeon Participants - None