Hand hygiene compliance >98%, do you believe it?

Stephen Dubner of SuperFreakonomics fame has an interesting post relaying a story by Dr. Jeffrey Starke from Texas Children’s Hospital in Houston. His hospital got their hand hygiene compliance rates to >98% by first making it part of the employee bonus plan and then part of the hospital executives’ performance bonus. Physicians got compliance that high even though they didn't fall under the bonus plans. Few details are given about amount and frequency of the bonus payouts, what the total cost was and what happened to their infection rates. However, I guess people do respond better to carrots than sticks.


  1. Although I believe it is long past time to set aside our nihilism about hand hygiene (e.g. that we can never get it over 60% for sustained periods of time), sustained adherence over 98% is higher than I've ever heard, and difficult to believe. The post describes them using "secret shoppers", but I wonder how secret, and what opportunities they were monitoring (entry, exit, both, more?).


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