How to get people to wash their hands properly, using behavioural science.

In the midst of the coronavirus crisis, the issue of proper handwashing has perhaps never before been so widely discussed. As governments around the world slowly begin to ease their lockdown measures, how will we ensure that proper handwashing behaviours continue in the places it matters the most?

Good hand hygiene isn’t only a coronavirus-related problem. Hospital-acquired infections, often brought in on the hands of visiting friends and family, have long been a significant issue worldwide. And correct handwashing by hospital staff themselves (often a full minute of handwashing is required or recommended by medical authorities) can also be a challenge. According to surgeon and researcher Atul Gawande, “The greatest difficulty is getting clinicians like me to do the one thing that consistently halts the spread of infections: wash our hands”.

So, we’d like to share one success story with you which combines our expertise in behavioural science and creativity…

The Challenge

We were approached by a global food production company, who tasked us with using behavioural science to improve the hand hygiene levels of workers in their factories. Specifically, we needed to get workers to wash their hands properly when entering and exiting the workplace.

Because these workers would be handling raw meat and food products, it was crucial that they washed their hands for around 60 seconds each time in order to kill all harmful viruses and bacteria. However, many workers would simply wash their hands until they ‘felt clean’, which often wasn’t long enough.

The factory had tried implementing more training for the workers, as well as printed materials emphasising the need to wash their hands properly, but these interventions had long lost their effectiveness. ‘Moral neutralization’ meant that that although the workers understood what needed to be done, they had essentially convinced themselves that their current handwashing behaviours were both acceptable and sufficient.

With this in mind, we set about designing a solution that would work effectively on a ‘System 1’ level, rather than relying on ‘System 2’ thinking each time.

The Hand Stamp

Our solution? To create a behaviourally-designed hand hygiene safety stamp. The stamp was in the shape of a bacteria and would be stamped on workers’ hands as they entered the handwashing facilities.

And here’s the clever part: the stamp contained a specially developed sticky ink, which took the same amount of time to wash off (around 60 seconds) as it did for workers to wash their hands properly.

As germs and viruses are so small as to be invisible, the stamp therefore acted as a strong visual feedback mechanism allowing workers to physically see whether they had washed their hands well enough, rather than simply washing until they ‘feel clean’. By making the invisible visible, the stamp meant that germs and viruses could no longer be overlooked so easily.

In parallel to this, the stamp — or lack of it — on their hands also then acted as an important social signal, further incentivising workers to wash their hands properly. After all, no one wants to be the one chump walking around with half a stamp still left on their hands, a clear signal to all their colleagues that they’ve not washed their hands properly.

Results

To test the effectiveness of the hand stamp, we used hand swabs to measure the percentage of workers returning a “dirty hands” result (“dirty hands” here referred to a total plate count exceeding 1000UPC, the industry-accepted safe limit)​.

When the results came back, we saw a 63% reduction in dirty hands across all shifts using the hand stamp, with the greatest reduction amongst the night shift workers.

Here at the Behavioural Science Practice, we believe that interventions like these can hold the power to solve some of the world’s stickiest problems. By using the combined power of behavioural science and creativity, we are able to discover ‘unseen opportunities’ like these and encourage better behaviours across the world.

Written by: Jordan Buck, Consultant at Ogilvy Consulting’s Behavioural Science Practice.