Hand hygiene "hall monitors": Leveraging the Hawthorne effect

Unfortunately, more than a decade after the World Health Organization's campaign launched, many centers still face challenges with low rates of hand hygiene compliance. Several electronic hand hygiene monitoring systems are available, and the cost of setup and maintenance varies by institution. At our institution, with extremely limited funds for complex interventions, we instead hired a pragmatic teenager in search of a summer job and trained her as a hand hygiene "hall monitor." We describe an effective, inexpensive intervention that improved our unit's hand hygiene performance while also providing youth employment.