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Bob Sutton has a terrific post describing how Cedars-Sinai Medical Center got all their doctors to wash their hands. He main source for the post is a New York Times Magazine article called Selling Soap by Stephen Dubner and Steven Levitt.

The hospital started out with 65% compliance. [Now this percentage is thrown into question by some Australian research which showed that when doctors were asked, using a survey, whether they wash their hands, 73% said yes. When the researchers observed their behaviour they only detected 9% compliance. Here is another reason to be careful in using surveys to understand what’s happening in a social system.]

Back to the Cedars-Sinai Medical Center. The first step they took was to reward anyone they saw washing their hands by handing out $10 Starbucks vouchers. This pushed compliance up to 85% but seemed to hit a ceiling.

They got the hospital up to nearly 100% by asking influential to place their hands in culture dish then photographing the bacteria and widely displaying the images, even putting one of the more disgusting as a screen saver for every computer in the hospital.

Both these examples are what I would call interventions. That is, a discrete, relatively small activities designed to change the system. It’s not a massive change program. It tackles one issue as a time and can make a huge difference. I think most large organisations get stuck into the mind-set of having to do the big programme—”we’re a big organisation, right!”

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Posted by: Tony Quinlan at September 28, 2006 1:20 AM

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