Heel Gewoon Handen Schoon
Enabling SVRZ to venture into behaviour design
Project Overview
In care settings, hand hygiene is of high importance to prevent infections. SVRZ is a large care organisation in Zeeland with 60 locations, providing elderly (day) care, medical rehabilitation and at home care. Their 3700+ employees have been trained on proper hand hygiene practices. However, during hygiene audits not all employees consistently showed the required behaviour. This mainly concerned the practice of keeping hands and wrists free: wearing no jewellery, no watch, and keeping nails short and natural (without nail polish or gel nails).
SVRZ needed an effective behaviour change strategy that could work in various care locations and care teams. A behaviour change solution was designed to stimulate and enable the desired behaviour. The solution contained elements of game play and focused on positive team results rather than individual employees’ compliance with rules. A low-fidelity prototype was created in order to test the effectiveness of the solution. The prototype test took place in April 2022 with care teams at 3 locations and showed positive results. SVRZ will make improvements to both the test and the prototype and then repeat the prototype test. This time with more teams participating and monitoring longer term effects and impact. With positive test results the next step is working from prototype towards minimum viable product.
“Heartbeat Ventures heeft SVRZ gedurende het volledige proces uitstekend begeleid: van het bedenken van een oplossing tot het implementeren van de pilot in de praktijk. Er werd over veel details van het project meegedacht, Annet/Heartbeat Ventures was erg betrokken en ook geregeld fysiek aanwezig, wat inspirerend heeft gewerkt.”
Action and Impact
In 2021 the Infection prevention team at SVRZ asked us for help on this behaviour challenge. We led them through a behaviour design process. The first step was utilizing SVRZ’s existing research and knowledge to understand the underlying reasons for employees to wear jewellery, watches or long polished nails to work. During a creative session together with SVRZ employees we then co-created behaviour change solutions that addressed these underlying needs and issues. We translated the outcomes of the creative session into a behaviour change strategy and designed a solution in which gamification, team effort and enabling conditions were key elements. In order to test the underlying assumptions and effectiveness of this solution, we coached the SVRZ team through setting up and executing the prototype test.
The ‘Heel Gewoon Handen Schoon’ prototype consisted of a team competition in which ‘empty’ hands, wrists and nails at the start of a work shift would increase a team’s score. A hand ‘scanner’ at the entrance was used by employees to scan their hands anonymously. The team earned points when hands and wrists were free of watches and jewellery and nails were short and natural. The scanner also served as a visual trigger to remember the favoured behaviour. The scanner was low tech; a ‘Wizard of Oz’ prototype, produced with some help of an artificial intelligence software company. It was not actually scanning, but just taking pictures; Behind the scenes, team members were executing functions of the prototype to convey the user experience.
During the test, the game was introduced and accompanied with positive communication. Good behaviour was rewarded, and focus was placed on the team rather than on the individual. Also, it was acknowledged that employees face challenges complying to certain hand hygiene rules, since these rules can interfere with personal motivations as well as social norms (e.g. wearing a wedding ring). Therefore, as employer, SVRZ played a key role to create enabling conditions for the desired behaviour:
Employees could have their wedding rings altered so that they can be taken off.
Employees could order a well-designed ‘storage- necklace’ on which they could wear, or show off, their precious rings and bracelets.
Lockers and storage for jewellery was offered as was nail polish remover on the spot.
A poster as part of the prototype describes additional tips and support to work with clean hands.
Beyond the prototype described above, in the ideal concept the team can earn points for other activities related to hand hygiene as well. Such as increasing the team’s awareness, knowledge or attitude through other gamified elements.
Impact in Numbers
In the prototype test, April 2022, we tested the assumption that friendly team competition would motivate employees to change their behaviour. Both in complying to the hand hygiene requirements as well as in creating a culture in which hand hygiene compliance can be addressed.
The prototype test showed several positive results:
3 SVRZ Teams, around 30 employees, were enthused and eager on scanning their hands
Self-reported compliance to hand hygiene requirements went up
Awareness on hand hygiene requirement rose
Addressing hand hygiene compliance became easier.
Contact person: Annet Bruil