Operations, Information and Decisions Papers

Document Type

Journal Article

Date of this Version

5-2015

Publication Source

Journal of Applied Psychology

Volume

100

Issue

3

Start Page

846

Last Page

862

DOI

10.1037/a0038067

Abstract

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.

Comments

This article may not exactly replicate the final version published in the APA journal. It is not the copy of record.

Keywords

workplace compliance, job demands, fatigue, work recovery, job design

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Date Posted: 27 November 2017

This document has been peer reviewed.