Date of this Version
Journal of Applied Psychology
To deliver high-quality, reliable, and consistent services safely, organizations develop professional standards. Despite the communication and reinforcement of these standards, they are often not followed consistently. Although previous research suggests that high job demands are associated with declines in compliance over lengthy intervals, we hypothesized—drawing on theoretical arguments focused on fatigue and depletion—that the impact of job demands on routine compliance with professional standards might accumulate much more quickly. To test this hypothesis, we studied a problem that represents one of the most significant compliance challenges in health care today: hand hygiene. Using longitudinal field observations of over 4,157 caregivers working in 35 different hospitals and experiencing more than 13.7 million hand hygiene opportunities, we found that hand hygiene compliance rates dropped by a regression-estimated 8.7 percentage points on average from the beginning to the end of a typical 12-hr work shift. This decline in compliance was magnified by increased work intensity. Further, longer breaks between work shifts increased subsequent compliance rates, and such benefits were greater for individuals when they had ended their preceding shift with a lower compliance rate. In addition, (a) the decline in compliance over the course of a work shift and (b) the improvement in compliance following a longer break increased as individuals accumulated more total work hours the preceding week. The implications of these findings for patient safety and job design are discussed.
©American Psychological Association, 2016. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. Please do not copy or cite without author's permission. The final article is available, upon publication, at: http://dx.doi.org/10.1037/a0038067
Dai, H., Milkman, K. L., Hofmann, D., & Staats, B. (2015). The Impact of Time at Work and Time off from Work on Rule Compliance: The Case of Hand Hygiene in Healthcare. Journal of Applied Psychology, 100 (3), 846-862. http://dx.doi.org/10.1037%2Fa0038067
Date Posted: 27 November 2017
This document has been peer reviewed.