Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-05T02:33:12.788Z Has data issue: false hasContentIssue false

The Hawthorne Effect in Infection Prevention and Epidemiology

Published online by Cambridge University Press:  18 September 2015

Luke F. Chen*
Affiliation:
Program for Infection Prevention and Epidemiology, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Duke University Medical Center, Durham, North Carolina Duke University CDC Preventions Epicenter Program, Durham, North Carolina
Mark W. Vander Weg
Affiliation:
Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa Department of Psychology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, Iowa
David A. Hofmann
Affiliation:
Department of Organizational Behavior and Strategy, Kenan-Flagler Business School, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Heather Schacht Reisinger
Affiliation:
Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa US Department of Veterans Affairs National Center for Occupational Health and Infection Control (COHIC), Gainesville, Florida
*
Address correspondence to Luke F. Chen, Duke University, Durham, North Carolina ([email protected]).

Abstract

The Hawthorne Effect is a prevalent observer effect that causes behavioral changes among participants of epidemiological studies or infection control interventions. The purpose of the review is to describe the origins of the Hawthorne Effect, to understand the term in relation to current scientific literature, to describe characteristics of the Hawthorne effect, and to discuss methods to quantify and overcome limitations associated with the Hawthorne Effect.

Infect. Control Hosp. Epidemiol. 2015;36(12):1444–1450

Type
Review Article
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Haessler, S. The Hawthorne effect in measurements of hand hygiene compliance: a definite problem, but also an opportunity. BMJ Quality & Safety 2014, doi:10.1136/bmjqs-2014-003507.CrossRefGoogle ScholarPubMed
2. Mayo, E. The Human Problems of an Industrial Civilization. New York, NY: MacMillan, 1933.Google Scholar
3. Jones, SRG. Was there a Hawthorne Effect? Am J Sociol 1992;98:451468.Google Scholar
4. Gittelsohn, J, Shankar, AV, West, KP, Ram, RM, Gnywali, T. Estimating reactivity in direct observation studies of health behaviors. Human Organization 1997;56:182189.CrossRefGoogle Scholar
5. Haynes, SN, Horn, WF. Reactivity in behavioral observation: a review. Behavioral Assessment 1982.Google Scholar
6. Kompier, MA. The “Hawthorne effect” is a myth, but what keeps the story going? Scand J Work Environ Health 2006;32:402412.Google Scholar
7. Parsons, HM. What happened at Hawthorne? New evidence suggests the Hawthorne effect resulted from operant reinforcement contingencies. Science 1974;183:922932.Google Scholar
8. Wickstrom, G, Bendix, T. The “Hawthorne effect”—what did the original Hawthorne studies actually show? Scand J Work Environ Health 2000;26:363367.Google Scholar
9. Kolata, G. Scientific myths that are too good to die. New York Times, December 6, 1998, p. WR2.Google Scholar
10. McCambridge, J, Witton, J, Elbourne, DR. Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol 2014;67:267277.Google Scholar
11. Dhar, S, Tansek, R, Toftey, EA, et al. Observer bias in hand hygiene compliance reporting. Infect Control Hosp Epidemiol 2010;31:869870.CrossRefGoogle ScholarPubMed
12. Berthelot, JM, Le Goff, B, Maugars, Y. The Hawthorne effect: stronger than the placebo effect? Joint Bone Spine 2011;78:335336.Google Scholar
13. Fakih, MG, Watson, SR, Greene, MT, et al. Reducing inappropriate urinary catheter use: a statewide effort. Arch Intern Med 2012;172:255260.Google Scholar
14. Greene, MT, Fakih, MG, Fowler, KE, et al. Regional variation in urinary catheter use and catheter-associated urinary tract infection: results from a national collaborative. Infect Control Hosp Epidemiol 2014;35:S99S106.CrossRefGoogle ScholarPubMed
15. Lee, KK, Berenholtz, SM, Hobson, DB, Demski, RJ, Yang, T, Wick, EC. Building a business case for colorectal surgery quality improvement. Dis Colon Rectum 2013;56:12981303.Google Scholar
16. Braykov, NP, Eber, MR, Klein, EY, Morgan, DJ, Laxminarayan, R. Trends in resistance to carbapenems and third-generation cephalosporins among clinical isolates of Klebsiella pneumoniae in the United States, 1999–2010. Infect Control Hosp Epidemiol 2013;34:259268.CrossRefGoogle Scholar
17. Cardboard cutout is an effective police officer. National Public RadioWeb site. http://www.npr.org/2013/08/07/209751426/the-last-word-in-business. Published 2013. Accessed August 25, 2015.Google Scholar
18. Ghosh, P. Cardboard cops patrol high-tech Bangalore’s busy streets. International Business Times, March 25, 2013.Google Scholar
19. Chen, LF, Carriker, C, Staheli, R, et al. Observing and improving hand hygiene compliance: implementation and refinement of an electronic-assisted direct-observer hand hygiene audit program. Infect Control Hosp Epidemiol 2013;34:207210.CrossRefGoogle ScholarPubMed
20. Muchinsky, PM. Psychology Applied to Work. Independence, KY: Cengage Learning, 2003.Google Scholar
21. Harbarth, S, Pittet, D, Grady, L, et al. Interventional study to evaluate the impact of an alcohol-based hand gel in improving hand hygiene compliance. Pediatr Infect Dis J 2002;21:489495.Google Scholar
22. Srigley, JA, Furness, CD, Baker, GR, Gardam, M. Quantification of the Hawthorne effect in hand hygiene compliance monitoring using an electronic monitoring system: a retrospective cohort study. BMJ Qual Saf 2014;0:17.Google Scholar
23. Creedon, SA. Hand hygiene compliance: exploring variations in practice between hospitals. Nurs Times 2008;104:3235.Google Scholar
24. McCarney, R, Warner, J, Iliffe, S, van Haselen, R, Griffin, M, Fisher, P. The Hawthorne Effect: a randomised, controlled trial. BMC Med Res Methodol 2007;7:30.CrossRefGoogle ScholarPubMed
25. Riggio, RE, Porter, LW. Introduction to Industrial/Organizational Psychology. New York, NY: HarperCollins College Publishers, 2003.Google Scholar
26. Quick, JC, Nelson, DL. Principles of Organizational Behavior: Realities and Challenges. London: South-Western Cengage Learning, 2011.Google Scholar
27. Olson, R, Verley, J, Santos, L, Salas, C. What we teach students about the Hawthorne studies: a review of content within a sample of introductory IO and OB textbooks. Industrial-Organizational Psychologist 2004;41:2329.Google Scholar
28. Jex, SM, Britt, TW. Organizational Psychology: A Scientist-Practitioner Approach. Hoboken, NJ: John Wiley & Sons, 2014.Google Scholar
29. Schmidt, NA, Brown, JM. Evidence-Based Practice for Nurses. Burlington, MA: Jones & Bartlett Publishers, 2014.Google Scholar
30. Ivancevich, JM, Matteson, MT, Konopaske, R. Organizational Behavior and Management. New York, NY: McGraw-Hill, 2002.Google Scholar
31. Newstrom, JW, Davis, K. Human Behavior at Work. New York, NY: McGraw-Hill; 2002.Google Scholar
32. Storey, SJ, FitzGerald, G, Moore, G, et al. Effect of a contact monitoring system with immediate visual feedback on hand hygiene compliance. J Hosp Infect 2014;88:8488.Google Scholar
33. Pronovost, P. Sustaining and spreading improvement in hand hygiene compliance. J Qual Patient Safety 2015;41:125.Google Scholar
34. Ivers, N, Jamtvedt, G, Flottorp, S, et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev 2012;6:CD000259.Google Scholar
35. Thomas, HC. Viral Hepatitis, 4th ed. Chichester, West Sussex: John Wiley & Sons, 2014, 1 (online resource).Google Scholar
36. Moore, ZS, Schaefer, MK, Hoffmann, KK, et al. Transmission of hepatitis C virus during myocardial perfusion imaging in an outpatient clinic. Am J Cardiol 2011;108:126132.Google Scholar
37. Baum, CG, Forehand, R, Zegiob, LE. A review of observer reactivity in adult-child interactions. J Behav Assess 1979;1:167178.CrossRefGoogle Scholar
38. Monahan, T, Fisher, JA. Benefits of “observer effects”: lessons from the field. Qualitative Res 2010;10:357376.CrossRefGoogle ScholarPubMed
39. Getting Around Hawthorne. Chaco Canyon Consulting Web site. http://www.chacocanyon.com/pointlookout/021002.shtml. Published 2002. Accessed August 25, 2015.Google Scholar
40. Pan, SC, Tien, KL, Hung, IC, et al. Compliance of health care workers with hand hygiene practices: independent advantages of overt and covert observers. PLoS One 2013;8:e53746.Google Scholar
41. Pan, SC, Lai, TS, Tien, KL, et al. Medical students’ perceptions of their role as covert observers of hand hygiene. Am J Infect Control 2014;42:231234.CrossRefGoogle ScholarPubMed
42. Biffl, WL, Gallagher, AW, Pieracci, FM, Berumen, C. Suboptimal compliance with surgical safety checklists in Colorado: a prospective observational study reveals differences between surgical specialties. Patient Saf Surg 2015;9:5.Google Scholar
43. Krediet, AC, Kalkman, CJ, Bonten, MJ, Gigengack, AC, Barach, P. Hand-hygiene practices in the operating theatre: an observational study. Br J Anaesth 2011;107:553558.Google Scholar
44. Ford, S, Birmingham, E, King, A, Lim, J, Ansermino, JM. At-a-glance monitoring: covert observations of anesthesiologists in the operating room. Anesth Analg 2010;111:653658.Google Scholar
45. Pineles, LL, Morgan, DJ, Limper, HM, et al. Accuracy of a radiofrequency identification (RFID) badge system to monitor hand hygiene behavior during routine clinical activities. Am J Infect Control 2014;42:144147.Google Scholar
46. Armellino, D, Hussain, E, Schilling, ME, et al. Using high-technology to enforce low-technology safety measures: the use of third-party remote video auditing and real-time feedback in healthcare. Clin Infect Dis 2012;54:17.CrossRefGoogle ScholarPubMed
47. Yin, J, Reisinger, HS, Vander Weg, M, et al. Establishing evidence-based criteria for directly observed hand hygiene compliance monitoring programs: a prospective, multicenter cohort study. Infect Control Hosp Epidemiol 2014;35:11631168.Google Scholar
48. Van Wart, M. Dynamics of Leadership in Public Service: Theory and Practice: Armonk. NY: ME Sharpe; 2005.Google Scholar
49. Padilla Bravo, C, Villanueva Ramírez, I, Neuendorff, J, Spiller, A. Assessing the impact of unannounced audits on the effectiveness and reliability of organic certification. Organic Agriculture 2013;3:95109.Google Scholar
50. Comeau, E, Lowry, D. Unannounced JCAHO survey. J Nurs Care Qual 2005;20:58.Google Scholar
51. Haas, JP, Larson, EL. Measurement of compliance with hand hygiene. J Hosp Infect 2007;66:614.Google Scholar
52. Usichenko, TI, Julich, A, Wendt, M. ‘Yes, we can’ utilize the Hawthorne effect to improve postoperative analgesia. Br J Anaesth 2013;110:659.Google Scholar
53. Feil, PH, Grauer, JS, Gadbury-Amyot, CC, Kula, K, McCunniff, MD. Intentional use of the Hawthorne effect to improve oral hygiene compliance in orthodontic patients. J Dent Educ 2002;66:11291135.Google Scholar
54. Lied, TR, Kazandjian, VA. A Hawthorne strategy: implications for performance measurement and improvement. Clin Perform Qual Health Care 1998;6:201204.Google Scholar
55. Clark, D. ‘Internet of Things’ in Reach. Wall Street Journal January 5, 2014.Google Scholar
56. Gershenfeld, N, Krikorian, R, Cohen, D. The Internet of things. Scientific American 2004;291:76.Google Scholar