Hospital hygiene

L’audit d’observance is the hand hygiene compliance audit, and l’observance is a false friend with a second trap waiting on the far side of it. In English, « observance » is the keeping of a rule, a fast or a feast day: religious observances, the observance of a treaty. French has that sense too — l’observance franciscaine is a monastic rule together with the community that follows it — but in a hospital the word has been taken over by medicine and narrowed. It now measures how far a patient, or a nurse, actually does what the protocol says. L’observance du traitement is adherence to treatment, and l’observance de l’hygiène des mains is what the auditor counts at the bedside. The English word for exactly that is « compliance » — and here the second trap closes, because French has borrowed « compliance » as well and handed it to physiology. La compliance pulmonaire is how readily a lung stretches, and it has nothing to do with obeying anybody. Each language keeps the other one’s word, and puts it to a different job.