MAPS published in The Wall Street Journal

How Undergrads Make Doctors Wash Their Hands

By Jacob Goldstein

Doctors and nurses don’t wash their hands as often as they’re supposed to. So we were interested to read about a program at UCLA Medical Center that managed to boost compliance with hand-washing guidelines from 50% to 93%, according to a paper published today in the journal Academic Medicine.

The trick was getting undergrads to volunteer to come lurk in the hospital.

By the time the undergrad program launched about five years ago, UCLA had been trying to improve hand-washing adherence for a while, with mixed results. A program that enlisted nursing staff to conduct peer audits of hand washing led to reports of 100% compliance — despite the fact that “feedback from patients and their family members, as well as from the staff and physicians who had been patients, indicated that not all staff members adhered to the standards.”

About 20 students per year are selected for the undergrad program (described at length here), and they record 700 to 800 observations per month. They look for compliance with hand-washing guidelines, as well as adherence to rules for giving medication and handing-off a patient for surgery (adherence to those measures have improved sharply as well since the program launched).

It’s possible that hospital staff have simply learned to follow the rules when undergrad volunteers are looking over their shoulders. Still, it seems reasonable to infer that the gains measured by the undergrads is, at least to some extent, a reflection of an overall improvement. And the program is cheap — about 0.3 FTE during the first year of the program, which fell to 0.1 FTE by the fourth year.


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