Positive Culture (Phase 3 of our Hand Hygiene Improvement Process)

By Clean Hands - Safe Hands

What kind of culture does your organization really have as it relates to patient safety?  Everyone wants to say that they have a rewarding culture that puts the patient first, but if most hospitals are honest, they typically fall short of this goal. Why is that?

It’s hard…really hard!

Taking care of patients is extraordinarily demanding and complex. Despite the tremendous training that all clinicians go through, they still are people at the end of the day. They get tired, have feelings, forget, make mistakes, have bad habits, and have opinions. In order to effectively change this, you need a combination of education, technology, and a refined process that is clinician-centered.

Improving hand hygiene, like most things in life, is best done with the proverbial “carrot” rather than the “stick.” Not only are carrots a more effective tool to motivate behavior, but they leave a much better taste in your mouth.

Our industry gets a well-deserved bad reputation as it relates to clinician culture for several good reasons. There are numerous systems on the market that passively record hand hygiene. Sure, you get a report and are held accountable, but just monitoring something doesn’t improve it. There’s no feedback or process change that occurs. At the end of the day, it is up to the clinicians to figure it out on their own, which is frustrating and futile.

Some electronic monitoring systems have “in the moment” feedback, which is great for trying to influence behavior change. That said, by design, many are negative and punitive. They use a combination of red lights and beeps on badges. The resulting scarlet badge of shame on a clinician’s chest may change behavior, but nothing can cause morale to plummet among hard-working clinicians faster than making them feel like they’re being called out or punished.

It doesn’t have to be that way. You can combine technology and “in the moment” feedback in a way that creates a positive culture of continuous improvement. Our emphasis is on changing behavior in order to increase hand hygiene and decrease HAIs…in a way that clinicians embrace rather than just tolerate.

Here’s how it works. During Phase 3 of our process (after gathering baseline data and then turning on our Natural Language Voice Reminder™), the fun really kicks in. We set up competitions and incentives that positively reward teams. Depending on the hospital and their data, we have done competitions among clinical units, day vs. night shift, or created teams within a unit for a March Madness®-like bracket. We’ve even thrown a Halloween-themed competition during the month of October.

We’ve found that gamification – combined with directed, positive reinforcement – is an effective tool to impact behavior change while establishing a patient-centric culture. Hospital executives are continually amazed by how much a pizza party or a couple of Starbucks® gift cards can do to drive change. The important thing is that people have fun and talk about change in a positive way. We consistently see that these types of games drive hand hygiene performance rates higher and higher.

Rather than identifying low performers and make them wear a scarlet badge of shame, we opt to publicly celebrate high performers and elevate them as role models for others.


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