An OPI-project funded by Central Jutland Region’s Growth Forum with participation from the Regional Hospital of Randers/Grenaa and Aarhus University Hospital.

The Objective

Today, about 10% of all patients admitted to Danish hospitals get hospital-acquired infections, which has major costs, both for the individual and society. To help address this problem, the project scope was to improve the hygiene behaviour of lavatory users as well as reduce sources of infection in the hospital environment.


The purpose of the project was to create innovative hygiene behaviour support solutions that could help reduce the massive cost to society connected with the high frequency of hospital acquired infections.

WHO estimates that in Europe alone, hospital-acquired infections are responsible for 16 million extra days of hospital stays, 37,000 deaths and a cost of about 7 billion Euro. The realisation that far too many people skip good hand hygiene after toilet visits gave us the courage to forge a new path. The hygiene behaviour support system was created through a combination of gentle nudging and hardcore behaviour modification.

The research and development process

With a focus on patients’ hand hygiene in connection with toilet visits, the project was centred on concrete user needs, user-centred development and the identification of the barriers to good hand hygiene.

Through thorough observation studies and by collecting real-time user behaviour data with IoT-systems, we produced significant new knowledge about hygiene behavior.

We constructed a full-scale mock-up of a patient lavatory for use in testing the newly developed products and IoT-system. In order to ensure maximum involvement of users (patients, relatives and staff) in the design- and development phase, we subsequently tested the solution for a long period, directly in clinical context, on a patient toilet, at the Regional Hospital of Randers/Grenaa.


Thanks to our many findings, the scope of the project has grown to include a desire to draw attention to the taboos associated with talking about hygiene.

The pre-test of patient hand hygiene showed that optimal hand hygiene, where the toilet visit is followed by the use of water, soap, paper and disinfectant, occurred only in just three percent of cases.

The results of the after-tests on the hygiene behaviour support system showed a significant improvement in hand hygiene concluding that optimal hand hygiene was practised in over sixty per cent of toilet visits, and ninety-five per cent of toilet visits were followed by the use of hand disinfectant.

More information / articles

OPI-project / Summary + Report

In 2013 the solution and patent was acquired by the international company Berendsen Plc. and succesfull market introduction has been achieved. More information.