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Making Hand Hygiene Purposeful

Patrick Boshell
August 14, 2013
Hand Hygiene Behavior

We all know that one of the most cost-effective ways to prevent healthcare infections is for doctors, nurses, and other healthcare professionals to regularly wash their hands, but often the frequency of hand washing is lower than expected.  Even worse, many of the efforts to get people washing their hands can often be ineffective.


Is there a better way to motivate those working inside hospitals to change their hand hygiene behavior?  Adam Grant, who is a professor at Wharton University along with Professor David Hofmann from the University of North Carolina set out to answer this question.  They conducted a series of behavior tests in a US hospital.  The results were recently featured in a bestselling book by author Daniel Pink - here's an excerpt.


"The two researchers went into a US hospital and obtained permission to post signs next to sixty-six of the hospital's soap and hand-sanitizer for two weeks. 


One third of those signs appealed to health care professionals' self interest:  HAND HYGIENE PREVENTS YOU FROM CATCHING DISEASES.  One third emphasized the consequences for patients, that is, the purpose of the hospital's work: HAND HYGIENE PREVENTS PATIENTS FROM CATCHING DISEASES. The final one third of the signs included a snappy slogan and served as the control condition: GEL IN,WASH OUT.


When they tabulated the results, they found that the most effective sign, by far, was the second one.  The amount of hand hygiene product used from dispensers with patient consequences sign was significantly greater than the amount used from dispensers with the personal consequences sign...or the control sign.


Intrigued by the results, the researchers decided to test the robustness of their findings nine
months later in different units of the same hospital.  This time they used only two signs - the personal consequence (HAND HYGIENE PREVENTS YOU FROM CATCHING DISEASES) and the patient consequences one (HAND HYGIENE PREVENTS PATIENTS FROM CATCHING DISEASES).  They also recruited hospital personnel  to be their hand washing spies, covertly recording when doctors, nurses and other healthcare staff faced a hand hygiene opportunity and how they responded.  Once again, the personal consequence sign had zero effect, but the sign appealing to purpose boosted hand washing by 10 percent overall and significantly more for the physicians.


Learn more about DebMed's Group Monitoring System (GMS).


Clever signs alone won't eliminate hospital acquired infections.  As surgeon Atul Gawande has observed, checklists and other processes can be highly effective on this front.  But Grant and Hoffman reveal something equally crucial: "Our findings suggest that health and safety messages should focus not on the self, but rather on the target group that is perceived as most vulnerable."


While we often assume that human beings are motivated mainly by self interest, a stack of research has shown that all of us also do things for what social scientists call "pro-social" or "self-transcending" reasons.  That means that not only should we ourselves be serving, but we should also be tapping others' innate desire to serve.  Making it personal works better when we also make it purposeful."


Please use the comments section below to share your feedback on other ideas to help improve hand hygiene behavior.


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