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Art Markman, Ph.D.

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How Do You Get Doctors to Wash Their Hands?

Posted: 01/12/12 11:29 AM ET

The field of medicine has understood the importance of hand washing for almost 200 years. The Hungarian Ignaz Semmelweis found that when people in an obstetric clinic washed their hands, incidence of infections plummeted. These days, hospitals have signs all over that remind patients and staff to wash their hands at every opportunity.

The fact that you need signs, though, suggests that not everyone is washing their hands all the time.

What kinds of signs are likely to be most effective?

Lots of research on persuasion suggests that a good message is one that requires people to take individual responsibility for their own personal consequences. A paper by Adam Grant and David Hoffmann in the December 2011 issue of Psychological Science, suggests that for health professionals it may be better to focus the message on consequences for patients.

The researchers explored this issue in two ways. In one simple study, they posted signs above the hand-sanitizing gel stations on a hospital. At some stations, the sign was a control sign ("Gel in, wash out"). At some stations, the sign emphasized personal consequences ("Hand hygiene prevents you from catching diseases"). At a third group of stations, the sign emphasized patient consequences ("Hand hygiene prevents patients from catching diseases"). Notice that these two signs differ by only one word.

The researchers measured the amount of sanitizing gel used in the two weeks before and after the signs were posted. The health care staff at the hospital was unaware that a study was going on. Neither the control nor the personal consequences signs increased the amount of gel used, but patient consequences sign increased gel use by almost 50 percent.

A second study looked at this even more carefully. The personal consequence or patient consequence signs were hung in different wards of a hospital. A trained member of the medical team observed the staff before and after the signs were put up to examine whether the staff washed hands immediately after patient contact.

The researchers found that general staff tended to wash their hands frequently regardless of the type of sign. For nurses, the personally consequence sign had no effect, but the patient consequence sign increased hand washing by about 11 percent. For doctors, both signs increased hand washing, though the increase was larger for the patient consequence sign (28 percent) than for the personal consequence sign (21 percent).

This research suggests that for busy health care professional who spend their lives caring for others, it is particularly effective to remind them of the responsibility they have to keep them washing hands.

More generally, though, in many work situations there are small things we can do to keep the work environment safer and to improve workplace performance. It may be helpful to have constant reminders of the influence of our actions on others to make sure that we do those small things to keep our world running smoothly.

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