Everybody's watching everybody
So in 2013, we decided to try a different approach. We said, from now
on, instead of having a few covert operators, everyone is going to be
responsible for making sure we all remember to wash our hands.
Everyone is going to pay attention to everybody, and we're going to
collect data on ourselves.
It was a radical change, and it led to a dramatic improvement. Our
overall compliance rate is now greater than 95% and it's been that high
for close to 2 years. While we're still processing all the numbers, we
also know we've had a corresponding decrease in our rate of health-
care-associated infections.
A big reason our performance has improved is that the new
approach gets a lot of non-traditional groups involved. A lot of our
infection prevention projects are focused on a narrow group of
employees, but this was something we could get virtually everyone
involved in — housekeepers, dietary staff and occupational, physical
and respiratory therapists — in addition to nurses and physicians.
We've seen a direct correlation between getting different groups
involved and seeing compliance improve in those groups. It also helps
that people aren't looking for that one person whose turn it is to be
hall monitor. That makes the data more meaningful. Now our whole
program operates on the Hawthorne Effect.
No undue burden
As you might expect, initially there was some concern about the idea.
People said, Oh I don't have time to do that. But we provided easy
ways to submit data and we required people to submit a certain num-
ber of observations every month. To record our hand-hygiene obser-
vations more efficiently, we use a mobile app called iScrub
(osmag.net/hndv3d), designed by the University of Iowa and the
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