Compliance and hand washing

Hand washing is one of the absolute basics of hygiene in food and beverage processing, but how do you ensure compliance?

Electronic monitoring can be one tool but it isn’t a guaranteed solution.

Olin Business School at Washington University in St Louis shows that motivating compliance with standard processes via electronic monitoring can be a highly effective approach, despite concerns about employee backlash. However, the research also highlights that managers cannot simply ‘monitor and forget’, and that a long-term plan for supporting the retention of monitoring is critical.

Hengchen Dai, assistant professor of organisational behaviour at Olin, along with Bradley A Staats and David Hofmann from the University of North Carolina at Chapel Hill and Katherine L Milkman from the University of Pennsylvania’s Wharton School, studied compliance with hand-hygiene guidelines among more than 5200 caregivers at 42 hospitals for more than three years.

They collaborated with Proventix, a company that uses a radiofrequency-based system to track whether healthcare workers wash their hands. More than 20 million hand-hygiene opportunities — incidences when hand hygiene is expected — were captured, each with the potential to prevent, or spread, a hospital-borne illness or infection.

The researchers found that on average, electronic monitoring resulted in a large increase in hand-hygiene compliance during their study period. Interestingly, compliance initially increased, and then gradually declined, after approximately two years. When electronic monitoring was stopped, hand-washing rates dropped, suggesting that hand-hygiene habits weren’t formed.

In fact, researchers discovered that compliance rates for hand washing dropped to below the levels seen before the monitoring began — a finding that is surprising to both the researchers and healthcare practitioners.

While the findings focused on the healthcare profession, Dai said all managers should take note, no matter their field. While electronic monitoring is an important motivation and compliance tool, it’s a single piece of a larger strategy.

“Individual electronic monitoring is one tool managers can use to dramatically improve standardised process compliance, but that it is not a panacea,” Dai said. “Managers looking to build process compliance must think about how electronic monitoring fits within a broader system encompassing not only technology, but also norms, culture and leadership. Managers should not ‘monitor and forget’.”

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