South Shore Health System puts an accent on safety

Hand Washing
Poster created by providers at South Shore Health System

Can the legendary “Boston accent” help promote hand hygiene?

The folks at South Shore Health System, about 15 miles south of the city, are saying, "Ya huh!"

Last fall, in an effort to promote more diligent hand-washing among health care providers, the hospital’s Hand Hygiene Committee and its Marketing and Communications Department created the “Didyah??” campaign. It features a video and posters playing on the distinctive way Boston-area natives pronounce words.

The posters say “Didyah??” in big letters and ask caregivers whether they’ve cleaned their hands with “Soap & Watah” or “Hand Sanitizah.” They were put up in common areas and restrooms; and at hand-washing stations, food stations, and other locales.

Lessons from hand hygiene campaign

  • In delivering messages that aim to change behavior, bold visuals and minimal text are the most effective means.
  • Not everyone is comfortable delivering just-in-time feedback. It is helpful to equip staff with easy, safe and specific language they could use to address missed hand hygiene opportunities.
  • Leadership sets the tone for the rest of the organization – physician leadership engagement, in particular, is key to inspiring change in behavior.
Adrienne Gerlach Head Shot
Adrienne Gerlach

‘Any infection is one too many’

The campaign is part of an effort to reach the hospital’s 2017 goal of reducing health care-acquired infections (HAIs), with an emphasis on catheter-associated urinary tract infections, surgical site infections, and central-line-associated blood-stream infections, according to Adrienne Gerlach, MPA, director of Quality Management.

“Like many organizations, our hospital has continued to fall short in maintaining our target of 100 percent compliance” with hand-washing, she said. “We are committed to driving preventable harm to zero and consider any infection one too many.”

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“This visual, with a touch of local humor,” she added, “has helped put hand hygiene at the forefront of our colleagues’ minds."

In addition to the poster, the Hand Hygiene Committee produced a “Didyah??” video (see below) that features hospital employees, leaders and even the health system’s CEO asking “Didyah??” in various scenarios.

A polite form of ‘just-in-time feedback’

The tone is purposely light. The phrase is treated as a friendly, non-judgmental expression that colleagues can use discreetly to deliver an immediate message about hand cleaning, explained Cindy DeLuca MSN, RN, CIC, South Shore’s Infection Prevention and Control Manager.

DeLuca added that staff members have “consistently relayed that they are not always comfortable delivering just-in-time feedback to individuals who missed a hand hygiene opportunity, especially if the individual is a person of higher authority or with whom they do not have a good working relationship.”

Reinforcing hand hygiene certainly makes sense. According to the Centers for Disease Control and Prevention, despite the body of evidence that demonstrates its effectiveness, on average health care workers clean their hands less than half the times they should.

Gerlach said the video was played at the organization’s “All Leaders” meeting and at hospital forums attended by hundreds of employees. It was also shown at the Quality Council meeting, the Medical Executive Committee meeting, Nursing Shared Governance meetings, the Patient Care Assessment Committee meeting, and department meetings. It is played during orientation for new hires.

“This message not only empowers colleagues to speak-up, but equips them with an easy way to do so,” Gerlach said.

Adrienne Gerlach can be reached at


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