How to Get Doctors to Wash Their Hands, Visual Edition

This photo is one of several developed for the Cedars-Sinai hand-hygiene campaign. There is an excellent, short Freakonomics podcast on the topic — highly recommended. And 25 January there is a brief update with links to some of the humorous Cedars-Sinai campaign materials. This campaign is directed by their “Zero Hospital-Acquired Infections Task Force”.

This is such a critical topic — a topic that hospitals largely do not wish to discuss. Few hospitals are as serious as Cedars-Sinai. Few hospitals know how many of their doctors practice adequate hand-hygiene. As patients how do we protect ourselves from the dirty doctors and all the other hospital pathways to infection?

In our latest podcast “What Do Hand-Washing and Financial Illiteracy Have in Common?,” we revisited a topic we wrote about a few years back: how one hospital (Cedars-Sinai Medical Center in Los Angeles) has tried to increase the rate of hand hygiene among its doctors. In the podcast, chief medical officer Michael Langberg regretfully reported that his doctors, like many doctors, routinely failed to wash their hands. Cedars-Sinai came up with a series of computer screensavers and posters that, along with some other creative measures, significantly jacked up the hand-hygiene rate.

Read the whole thing »

There are a few public documents coming out of Cedars-Sinai, though I’ve not found any publications on their current infection control performance, or policies/procedures (other than OR surgical hand scrub, but I don’t think the OR is where the problem is). In one of their pubs on MRSA, Super Staph, on the effects of anti-cholesterol drug BPH-652, there is a sidebar outlining the hand-washing campaign:

The Best Weapon, Hands Down.

The rule is clear: Doctors and nurses are supposed to wash their hands or use a Purell® dispenser before they enter and leave a patient room. For various reasons—not only at Cedars-Sinai but at hospitals everywhere—compliance with this rule falls short of the 100 percent goal. Sometimes, in the rush to get to the next patient, healthcare professionals simply forget to wash their hands. Or they might figure it’s not necessary because they were only in a patient’s room briefly and didn’t touch anything.

Making sure everyone complies with hand-washing guidelines without fail is the goal of a hospital-wide campaign at Cedars-Sinai that involves educating all employees, as well as patients and visitors, about the fact that hand hygiene can, indeed, save lives. New custom-designed kiosks in visitor waiting areas provide Purell® dispensers, masks and tissues and display the message, “The power is in your hands. Please help us protect our patients’ health.”

Erica Palys, MD, an infectious disease fellow who helps lead the hospital’s hand hygiene task force, says trying to get people to change their routine is a challenge, especially when they can’t directly see the results of their actions. “If you don’t wash your hands, there is no visible consequence—you don’t see that person down the line who could get sick or die. We’re making hand hygiene as convenient as possible so that it becomes easy to do the right thing without even thinking about it.”

In the same bulletin see also the informative “Staff vs. Staph” sidebar which closes with this:

“It all comes down to a common goal,” notes Dr. Langberg, who devotes five to 10 hours a week to the task force. “We realized that if anyone of us is a patient coming to the hospital we shouldn’t walk out with a bug we didn’t have. It’s a priority for all of us.”

Could technology help us overcome this human-social challenge? I think so, read on…

1 thought on “How to Get Doctors to Wash Their Hands, Visual Edition

  1. What do you do when constant hand washing causes cracked and bleeding skin? Could it be that failure to wash hands is the result of trying to avoid cracked and bleeding skin?

    I used to use hand sanitizer immediately after petting my dog, but I had to stop; it caused skin problems.

    Why assume that the failure of doctors and nurses to wash or sanitize their hands is always the result of fogetfulness?

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