In California Hospital, Hand Hygiene Campaign was run for 90 days and there was a bonus announced of $1,200.
On average, bonus-eligible hospital employees improved their performance during the 90 days of the initiative, but then progressively trailed back to levels of performance as low or worse.
Physicians who were not eligible for bonus and demonstrated a slower improvement relative to the other employees, but maintained a significantly improved hand hygiene performance over the remainder of the period.
What was the incentive for the Physicians?
Physicians cannot be hospital employees. Because of this, their hand hygiene performance would contribute to achieving the hospital-wide goal but they would not be eligible to receive any performance bonus.
Thus, the employees devised various creative ways to put pressure on doctors, albeit informally and not in the form of cash.
Physicians that demonstrated good hand hygiene practices would have their names written on hand-shaped paper cards and posted on a wall, for examples. The chief nursing officer would send physicians “love notes”: celebratory emails underlying good performance, or respectful — but firm — reminders of the importance of their cooperation to achieve the collective goal, depending on the physician’s observed behavior.
In essence, while monetary incentives generated a more pronounced improvement, it was short lived. On the other hand, peer pressure techniques generated a change in organizational behavior that persisted beyond the removal of the incentive.
Source: HBR, Incentives Don’t Help People Change, but Peer Pressure Does by Susanna Gallani
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