Institute For The Future

What's up Doc? Did you remember to wash your hands?

 

A couple of years ago, Atul Gawande described in the New Yorker a study designed by Dr. Peter Pronovost of Johns Hopkins in which he implimented a short checklist to see if it could decrease a frequent problem in intesive care units -- intravenous catheter infections.  The results, published in the New England Journal of Medicine, were oustanding; following five simple steps led the rate of catheter related bloodstream infections to drop 66%.The first step was "wash hands with soap."

A recent post on the Nudge blog—hosted by Cass Sunstein and Richard Thaler, authors of the well-known book of the same title—described a different tactic for getting medical personnel to wash their hands: secret agents!

 

In Maryland, state leaders recently kicked off a program that will send 45 teams of observers to 47 hospitals to record the hand-washing habits of doctors and nurses. Governing Magazine calls the teams spies. They have to be anonymous in order to alleviate the potential Hawthorne effect.

The Hawthorne effect demonstrates that subjects will improve an aspect of their behavior being experimentally measured simply in response to the fact that they are being studied.

The Governing Magazine piece notes that "the main benefits of the Maryland Hospital Hand Hygiene Collaborative are the creation of a system for officials to share best practices and uniformly report progress, and to raise awareness about the importance of keeping hands clean while dealing with patients" (emphasis added).  Duh.

Hospital-acquired infections, which account for 1.7 million infections annually, are among the leading causes of preventable death in the U.S.: 100,000 deaths and $30 billion in additional health care costs, according to the Centers for Disease Control and Prevention. Maryland hospitals hope that improving hand washing will reduce such infections and the costs associated with them.  Making people more likely to change their behavior simply by watching them—or providing them with a checklist that reminds them to do so—whatever it takes to change their behavior for the safety of us all.