How to Get Doctors to Give a Hand

We all know that hand washing is essential to our hygiene, and this is especially true for doctors and nurses: It’s the single most important factor to preventing infections in hospitals.

Yet studies show that health care professionals wash their hands less than half the time they should; one recent study found that the hand-washing rate hovered around 25 percent in intensive care units. How can we make sure that doctors and nurses scrub their hands when they’re wearing their scrubs?

A new study offers one effective strategy: The trick, it seems, lies in stressing the health benefits to their patients rather than themselves.

In the study, forthcoming in the journal Psychological Science, researchers compared the effects of two different signs each placed above 22 soap and gel dispensers at a hospital. One sign said, “Hand hygiene prevents you from catching diseases”; the other said, “Hand hygiene prevents patients from catching diseases,” emphasizing patient (as opposed to personal) consequences.

The researchers had a team monitor the hand-washing habits of doctors, nurses, and other hospital staff before the signs went up, then put the signs up for two weeks and looked for changes.

The results show that when doctors and nurses were confronted with the signs mentioning their patients, they were 10 percent more likely to wash their hands than they had been before, and they used 33 percent more soap. The other signs didn’t produce any changes in hand-washing habits.

This challenges a longstanding assumption in the health care world: that to capture the attention of busy professionals and encourage hand hygiene, it’s necessary to appeal to their immediate self-interest.

Instead, it seems, appealing to their concern for others has far greater sway, even when we raise that concern through a very slight environmental change—as innocuous as a small sign over a soap dispenser.

This finding suggests that to promote a healthy behavior, health and safety officials should highlight its benefits not just for oneself but rather for other people, especially for a group that is perceived as vulnerable. That may be a more effective way of both improving a community’s health while also fostering an altruistic mindset.

The study’s authors suggest that their work has important implications for encouraging other positive and healthy behaviors, well beyond hand washing.

“Are people more likely to improve exercise and eating habits, quit smoking, purchase life insurance, wear seatbelts and helmets, protect the environment, or take prescription medication,” they write, “when reminded of the consequences for their families rather than themselves?”