The carrot and stick is outdated: Why your hand hygiene program needs a positive feedback loop

Carrot and StickThe carrot and the stick approach. An old idiom used to describe two opposite methods to motivate behavior change. A cart driver dangling a tasty carrot in front of a mule. The mule moves towards the carrot motivated by the reward of food (reward). The stick, on the other hand, is the painful consequence of not moving in the cart driver’s desired direction (punishment).

So what does a root vegetable and a piece of wood have to do with improving hand hygiene compliance? Would rewarding employees with cash and prizes sustain 100% hand hygiene compliance? Would the threat of penalties or formal reprimand motivate hand hygiene offenders to change their ways?

I think we should look at an alternative to the “carrot and stick.” A positive-feedback loop. This is something I learned from a mAiRiner client. Picture a medical unit (or a long term care home area and they are given a target they are required to reach each month (e.g. 95% hand hygiene compliance. If the unit achieves 95% compliance they are notified. This could be done verbally or in writing. All of the staff receives a collective pat on the back. Everyone is happy. So what happens if they don’t reach their target? Instead of punishment they are required to come up with a S.M.A.R.T. goal – a specific, measurable, achievable, realistic and time-oriented plan to turn their situation around and get them back on track to achieve their desired target. It’s more effective than a punishment because it’s much more motivating. And it’s sustainable because by the next month they will be able to see if the changes they’ve made are having the desired impact. If they do, everyone wins. If they don’t, they can fine tune, make the necessary adjustments and proceed. Put simply, a positive-feedback loop is created.

Let’s leave the carrot and stick for colloquial times. A positive feedback loop is much more effective for today’s workplace environment. Would this approach work in your facility? Here’s some homework for you. Look at your lowest performing areas and ask yourself, “How can I incorporate a positive feedback loop? Have I set clear targets for each medical unit to achieve? Are these targets clearly visible to everyone? Who takes responsibility when hand hygiene goals aren’t met? Do I have buy-in from senior management? Are they fully on-board? If not, why? “

If you want to learn about some specific tools mAiRiner has available, please get in touch with me.

Until next time,

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