5 points on improving physician compliance to hand hygiene practices

Healthcare organizations that employ a peer pressure approach to hand hygiene can increase physicians' compliance.

Susanna Gallani, PhD, an assistant professor of business administration at Boston-based Harvard Business School, discussed her study in Harvard Business Review.

Dr. Gallani analyzed a California hospital that implemented a 90-day hand hygiene improvement initiative. Hospital employees would receive a $1,200 bonus if they met the target performance. However, California law prohibits physicians from qualifying as hospital employees, so the hospital employed other strategies to increase provider compliance.

Here are five points:

1. The hospital would write physicians' names on paper if they had good hand hygiene practices. Employees would post these names on a wall, as well.

2. The chief nursing office sent congratulatory emails to those top performing physicians and would send "respectful but firm" reminders to physicians to remind them of the collective goal.

3. Following the 90 days, Dr. Gallani found employees who received bonuses improved their hand hygiene performance during the initiative, but their performance became gradually worse than before the initiative.

4. Physicians showed a slower performance improvement during the 90 days, but had a substantially better hand hygiene performance over the remainder of the observation period.

5. Dr. Gallani writes in the Harvard Business Review, "While monetary incentives generated a more pronounced improvement, it was short lived. On the other hand, peer pressure techniques generated a change in organizational behavior that persisted beyond the removal of the incentive."

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