Surveys, rewards and shame

Posted by  Shawn Callahan —September 27, 2006
Filed in Anecdotes

24freak.190Bob Sutton has a terrific post describing how Cedars-Sinai Medical Center got all their doctors to wash their hands. His main source for the post is a New York Times Magazine article called Selling Soap by Stephen Dubner and Steven Levitt.

The hospital started out with 65% compliance. [Now this percentage is thrown into question by some Australian research which showed that when doctors were asked, using a survey, whether they wash their hands, 73% said yes. When the researchers observed their behaviour they only detected 9% compliance. Here is another reason to be careful in using surveys to understand what’s happening in a social system.]

Back to the Cedars-Sinai Medical Center. The first step they took was to reward anyone they saw washing their hands by handing out $10 Starbucks vouchers. This pushed compliance up to 85% but seemed to hit a ceiling.

They got the hospital up to nearly 100% by asking influential to place their hands in culture dish then photographing the bacteria and widely displaying the images, even putting one of the more disgusting as a screen saver for every computer in the hospital.

Both these examples are what I would call interventions. That is, a discrete, relatively small activities designed to change the system. It’s not a massive change program. It tackles one issue as a time and can make a huge difference. I think most large organisations get stuck into the mind-set of having to do the big programme—”we’re a big organisation, right!”

About  Shawn Callahan

Shawn, author of Putting Stories to Work, is one of the world's leading business storytelling consultants. He helps executive teams find and tell the story of their strategy. When he is not working on strategy communication, Shawn is helping leaders find and tell business stories to engage, to influence and to inspire. Shawn works with Global 1000 companies including Shell, IBM, SAP, Bayer, Microsoft & Danone. Connect with Shawn on:


  1. Tony Quinlan says:

    A great example, Shaun, thanks. And also – tapping into those other areas we share – a good example of using the social network and the heroes/stories instead of some spirit-stifling dictat cascaded down through corporate comms channels.

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