The Impact of Structured Incentives on the Adoption of a Serious Game for Hand Hygiene Training in a Hospital Setting.

Abstract

Hand hygiene is recognized by the CDC as the most effective method of preventing Hospital Acquired Infections (HAIs) which cost the US healthcare system $14 Billion. However, training and promotion of hand hygiene in healthcare settings is an on-going challenge. This paper describes a hand hygiene improvement campaign in Edinburgh Royal Infirmary (Scotland, UK) using the SureWash gesture recognition system (SureWash, IRL). The campaign consisted of two phases of three-months each; the first phase involved technology evaluation and familiarization in a variety of settings within the hospital. The second phase involved rotation between two units with specific changes to the incentives for completing the training. There were 2,010 individual training sessions with over 30% outside of office hours. Individuals completed an average of 2.72 training sessions each and 90% of staff passed the assessment. Senior staff noted a change in hand hygiene culture following the campaign and the good-natured competition between staff to demonstrate hand hygiene competence using the SureWash serious game. While the new technology did facilitate the culture change its successful implementation was dependent on a set of incentives for staff and a structured implementation plan.