How can you incentivize a team of healthcare professionals to change longstanding behaviors? Motivations such as money, being observed, peer pressure, or other incentives might work in the short term, but how do you get someone to permanently change a behavior?
There are many theories about the psychology of changing one’s habits, but we’re specifically interested in understanding the psychology of performing effective hand hygiene.
Hand hygiene compliance is a critical element in the fight against dangerous and deadly healthcare-acquired infections (HAIs). With roughly one-in-25 hospital patients contracting an HAI every day, HAI prevention through proper hand hygiene is a top concern among healthcare institutions nationwide. After all, compliance to proper infection control protocols, including hand hygiene, could literally mean the difference between life and death for certain patients.
With new and improved hand hygiene products comes the need for facility-wide adoption and compliance of effective and proven hand hygiene practices from healthcare workers. In today’s growing healthcare industry, what influences a healthcare professional to follow or not follow hand hygiene compliance rules? Could it be:
- They comply out of fear of discovery by others if they’re doing it wrong or not doing it at all
- They comply because it’s the right thing to do
- They comply because they understand the importance of it and the science behind it
- They comply to receive an incentive such as a monetary reward
- They don’t comply because everyone else is doing it too
- They don’t comply because it takes too long, is inconvenient, or interrupts their usual work
- They don’t comply due to a skin health reason such as chapped hands
- They don’t comply because they perceive the way they do it now works just fine
- They don’t comply because they forget
In a recent study published by the Harvard Business School, a researcher compared the adoption of hand hygiene behavior modifications at a California hospital between two groups: one receiving monetary rewards for a team behavior change and the other relying solely on the implicit incentive of an organizational behavior modification, a.k.a. peer pressure. The researcher found that the group receiving monetary incentives were more likely to adopt the new hand hygiene behaviors initially, but that those changes were relatively short-lived compared to the group exposed to peer pressure only.
But why is that? It seems that social pressure and the desire to succeed for the benefit of the entire group is a more powerful and lasting motivator.
We have much to understand when it comes to the psychology of hand hygiene and compliance, and appreciate the work done by researchers such as Dr. Jocelyn Srigley and Susanna Gallani in helping healthcare facilities improve their hand hygiene and compliance efforts.
Essential moments to perform hand hygiene*:
- When entering a patient room, apply an effective hand sanitizer. Use an alcohol-based sanitizer or rub that contains at least 60 percent alcohol to decrease transient bacteria and reduce the risk of cross-contamination between patient rooms.
- Clean hands before performing any type of aseptic procedure to protect the patient against harmful pathogens, including germs carried by healthcare professionals or ones living on the patient’s own body.
- Clean hands after exposure to, or the threat of exposure to, bodily fluids. This will protect the healthcare worker from the patient’s germs and limit the spread of infection-causing pathogens.
- Clean hands after touching a patient or any of the patient’s immediate surroundings, such as the patient’s clothes or gown, hospital bed or exam chair.
- Clean hands after touching any object in the patient’s room, including high-touch surfaces such as door handles, bed railings, chairs, countertops, etc.