The more I visit different hospitals, the more I tend to roll my eyes at the different signs that aim to remind staff and/or visitors to follow proper hand hygiene practices. These signs are often part of an arms race (among sign manufacturers, I presume) to see whose signs can be the cutest or most clever. I've seen signs that include:
- Cartoon microbes
As I've written about before (“My Anti-Handwashing-Poster Poster“), these signs might be well intended, but I think they miss the point. If signs and reminders worked, we would have solve the hand hygiene “compliance” challenge long ago. But thanks to an anonymous reader, I have a new sign to add to the collection… involving a monkey – a sign that was hanging in a public corridor (“part of a series of different monkey posters,” says the emailer).
Maybe that's more of a baboon than a monkey? I don't know. But it doesn't look like hospital staff members I know. I'm not sure if apes wash their hands (zoologists, chime in?). They're purported to fling poo at each other to mark their territory. So, yeah, that probably spreads infection… but the lesson for hospital staff members?
Amongst all of the other reminders about hand washing, it seems this sign might be the most troublesome or offensive. What's the thought process of the person hanging the signs? I really don't understand how this sign would help. Even a more direct sign like this one makes sense, but might not lead to 100% compliance.
Instead of lecturing, embarrassing, or haranguing staff and physicians, I'd argue that hospital leaders should follow Lean leadership practices, including:
- Leaving the office to go to the “gemba,” or the place where work is done (or where patient care is provided)
- Talk with staff members to collaborative identify barriers to hand hygiene, working together on countermeasures
Instead of blaming, work together. Do you need to hang more gel dispensers? Do you need to help eliminate waste from the workday so staff members have enough time to follow proper hand hygiene practices? Can you physically error proof the process (as was done in this video)?
If you have cute or lecturing signs in your hospital, send it to me via email (mark at leanblog dot org) and I'll post it anonymously in this post.
Patients and the public are becoming more aware of hospital acquired infections – the sheer number of them that occur and how preventable they can be. Maybe patients, in the future, will be more impressed with data and infection prevention results than they will be by signs in the hallways?
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