At Abington Memorial Hospital in suburban Philadelphia, poor hand hygiene habits could cost you your job. This month the 665-bed non-profit hospital will add teeth to its hand-hygiene program, which already involves staff members — so-called "spies" — observing whether their colleagues use hand sanitizer when entering and leaving rooms.

If a spy spots someone who neglects this hand hygiene basic, she will hand the staff member a small card noting her non-compliance. Any employee who receives 3 cards risks her contract, which is renewed every 2 years. Employees who exhibit exemplary hand hygiene habits, on the other hand, will receive cards entering them into a raffle.

Abington Memorial established its hand hygiene monitoring program about 2 years ago and records 800 to 1,400 observations a month. As a result, compliance among its employees has gone from 31% to 88% and seems to have leveled off at 80%, according to a published report. The 3-card program aims to get hospital staff closer to 100%.

"Our goal is to continually push down the risk of preventable harm," John J. Kelly, MD, the hospital's chief of staff told the Philadelphia Inquirer. "What's more serious than somebody dying from a hospital-acquired infection that you could prevent?" Hospital representatives were not immediately available to comment for this article.

Kent Steinriede