An Unlikely Place: Incentives in Hospitals

6 min read

What would you say if I told you that doctors, hand washing, and incentives all have something in common? Before you strain yourself too much connecting the dots, you may want to take a quick peak at this article At Xactly, we’re always on the hunt for out of the box incentives, and we’re used to finding them in the most unique places. We’ve seen and heard of everything from wedding planners to truck drivers using our tools to help them better understand their incentive compensation. But when this article popped up about hospitals leveraging incentives to get their doctors to wash their hands, our attention was caught. First, to have this article they had to admit that doctors don’t wash their hand nearly enough (ew!), and second, the result of this article proved that incentives are a powerful tool for encouraging behaviors and promoting growth in any area. In this case, it was the behavior of the staff and the improvement of hygiene and patient wellness that benefited from incentives. So how did this all come about, you ask? Well, I’ll tell you: according to the Centers for Disease Control and Prevention, hospital-acquired diseases cost upwards of $30 billion dollars and lead to nearly 100,000 patient deaths per year. With staggering numbers like this, hospitals were desperate to reduce the risk associated with disease transmission. From previously conducted studies, hospitals already knew that without encouragement, hospital staff on average washed their hands for as little as 30% of the time they spent with patients. Since we’ve all been told since we were young that germs spread through our hands, improving hand washing frequency was an easy and appropriate place to start. Depending on the hospital, different procedures were put in place. There were the high-tech hospitals, who installed alarm systems and cameras in various rooms to catch those that didn’t wash their hands before interacting with patients; there were more covert hospitals, that planted “spies” in rooms to place “red cards” in the unwashed hands of observed offenders; and then there were the compensation hospitals, that employed incentives like gift cards and cash bonuses to reward doctors and medical staff for their efforts in washing their hands. When Incentives and Recognition Work So, what is the effect of any of this effort? As you may well know, data is worthless without analysis, and without observation this cleanliness campaign wouldn’t amount to much more than the initial success it gained. That’s where Arrowsight comes in. Arrowsight, a video system company, has conducted a few trials to see how tracking and recognizing employees for washing their hands can change habits. In the North Shore study, which is published in the journal Clinical Infectious Diseases, workers were tracked for a 16-week period. Results from each day were shared with staff on scoreboards and through email and handwashing rose an amazing 88% (that’s up from 10% when they didn’t know they were being tracked). The North Shore hospital is still using this system in their intensive care unit, where hand washing is of utmost importance. So, effective incentives, powerful data, and meaningful change: what’s not to like about this story? The power of incentives has always lived in their ability to make any desired behavior the obvious choice, and nowhere is that more evident than in washing your hands - sure it may seem obvious to us, but when it becomes a vital minor function of your job, it’s easy to see how something like keeping your hands clean could get lost in the fray. In a high stakes environment, it’s the little things that make the biggest impact, and as these researchers learned, incredible human and financial costs resulted from such simple oversight. It is always inspiring to see impactful results from the application of incentives, and we’re eager to find the next big story to push the art of incentivization even further.