'One size fits all' is no way to improve hand-hygiene compliance

With hand hygiene a key factor in the fight against deadly hospital-acquired infections, the Joint Commission Center for Transforming Healthcare decided to tackle the issue by conducting its first patient safety project on the subject, the results of which are published in several articles in the Joint Commission's Journal on Quality and Patient Safety.

In the first article, the Joint Commission details its attempt to improve hand hygiene at eight hospitals by using data-savvy change management methods to target specific areas of noncompliance.

In the beginning of the project, compliance was at an average of 47.5 percent across the hospitals, with the Joint Commission identifying a total of 41 causes of noncompliance. After the accrediting agency employed its three trademark tools to target interventions at each of the hospitals tailored to specific causes of nonadherence, compliance improved to 81 percent across all eight hospitals, according to the article.

"Such a targeted approach may be more effective, efficient and sustainable than 'one-size-fits-all' strategies," the article concludes, adding "If one does not know exactly why hand hygiene is failing and which specific causes are most prevalent in a particular hospital, it will not be possible to devise an effective set of interventions."

After its initial project, the Joint Commission used its findings when working with another 19 hospitals to create a web-based "Targeted Solutions Tool" to enable healthcare organizations to use the same methods employed by the original eight hospitals, according to another article in the journal, titled "Beyond the Collaborative: Spreading Effective Improvement in Hand Hygiene Compliance."

Using the Joint Commission's tool from 2008-2010, 289 healthcare organizations initiated a total of 1,495 projects to improve hand-hygiene compliance, and were able to improve their average compliance from 57.9 percent to 83.5 percent--similar results to the original eight hospitals, according to the article.

The Joint Commission is not the first organization to tackle the stubborn issue of improving hand-washing compliance rates in healthcare facilities. Past research into the subject has indicated that improving patients' own hand hygiene and leveraging consequences could be crucial, and another study suggested that a simple social tool like peer pressure is effective in improving compliance, as healthcare staff were found to improve their hygiene habits when in their coworkers' presence, FierceHealthcare previously reported.

For the Joint Commission's part, the organization learned from its hand-hygiene project that using business-tested models and statistics may be the best way to go about improving compliance among healthcare workers that will in turn lead to better patient care, wrote Peter Pronovost, M.D., of the Johns Hopkins School of Medicine, in an editorial published in the journal.

"In the struggle to find the balance between art and science, patients would be better served if more emphasis was placed on management science," he wrote.

To learn more:
- check out the articles (subscription required)
- see the project details
- read a statement about the project

Suggested Articles

Major health groups raised alarm following the announcement by President Donald Trump that the U.S. is terminating its relationship with WHO.

A greater number of health systems may fall short of agreements tied to their borrowing compared to prior years, according to a new report.

In 2019, the World Health Organization declared 2020 the Year of the Nurse. Few would have guessed this designation would coincide with COVID-19.