Directed Prompts
The National Institutes of Health has funded Amron Corporation's work in behavior modification through voice messages for the last seven years. We installed the Small Business Innovative Research (SBIR) Phase I precursor to Hand Hygiene Monitor (HHM) at a residential unit for Alzheimer's disease patients and at a pediatrician's office. The result was that voice prompts increased handwashing compliance significantly.

The subsequent Phase II SBIR grant was carried out at Johns Hopkins (JHH) Hospital in Baltimore, MD and at Biloxi Specialty Hospital (BSH), in Biloxi, MS. HHM prompted for hand hygiene upon exiting a patient room at JHU and upon entering a patient room at BSH. Baseline hand hygiene compliance was established without prompting in the Pre test phase, compliance in response to voice prompts in the Test phase, and the extent of learned compliance in the Post test phase, where no prompts were delivered. Hospital personnel recorded the infection rate during all three phases.


Random Prompts
We installed a HHM at NorthEast Methodist Hospital in San Antonio, TX, in a Phase I SBIR study. There, HHM not only recorded soap and sanitizer use, but also played voice messages, at random times, encouraging good hand hygiene. Compliance with hand sanitizer increased by 34% to 65% when voices played, depending on the identity of the speaker. We have not published these results, but they justified a Phase II SBIR grant from the National Institutes of Health (NIH), which we are now carrying out at six different hospitals in the Johns Hopkins Hospital chain.