Curious Cat Management Improvement Blog: Deming, lean thinking, innovation, customer focus, continual improvement, six sigma.
October 3, 2006
Evidence-based Management

Bob Sutton’s writing includes the excellent article “Management Advice: Which 90% is Crap?” (which we discussed in: Management Advice Failures) and the Knowing Doing Gap. I just discovered his blog today which is quite good: Work Matters. A recent post - Hand Washing and Evidence-based Management, includes some good advice on data and process improvement:

I’ve written before about how handwashing by medical care workers is one of the most well-documented preventable causes of death and disease in health care settings.

Self-report data can be worse than useless. They describe an Australian study where 73% of doctors reported washing their hands, but when the docs were observed by a researcher only 9% were seen washing their hands.

The way they finally got compliance up to nearly 100% was to have a group of the hospitals more influential doctors each press their palms on plates that were cultured and photographed, which resulted in images that “were disgusting and and striking, with gobs of colonies of bacteria.”


It is not easy to get people to change their habits. You often need creativity to give power to the data (like the photographs above). A previous post here also discussed hand washing, data collection and health.

Finally, this story, to me, is another sign that focusing on managing the system is more important than devoting excessive energy to bringing in star talent

the compliance rate was only about 65% until management started changing the system, first through rewards (which got them up to 80%), and then through those disgusting pictures (which pushed them to close to %100). These are all the same people, they were just managed differently.

Great stuff.

Related: Curious Cat Management Blog Directory - Measurement and Data Collection - Dangers of Forgetting the Proxy Nature of Data - Miracle Drugs vs. Superbugs, Preserving The Usefulness Of Antibiotics

One Response to “Evidence-based Management”

  1. Curious Cat Management Improvement Blog » Information Quality In Health Care Says:

    I believe poor information and the inability to make medical decisions with correct, complete and timely information kills more people than any single disease in the United States…

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