Hand-washing adherence is on the up-and-up as more hospitals are holding their leadership accountable for hand hygiene, patient safety watchdog The Leapfrog Group reports.
Since it began collecting and reporting data on hospital hand hygiene in 2020, the percentage of hospitals meeting Leapfrog’s hand hygiene standard has risen from 11% to 74% in 2023, according to numbers from 2,149 surveyed hospitals released Wednesday.
Meeting the requirement requires hospitals to mandate best practices recommended by its expert panel and adapted from World Health Organization framework guidance. These requirements span five broad areas: monitoring, feedback, training and education, infrastructure (i.e., access to hand-washing supplies) and culture.
Though Leapfrog’s report outlines a sevenfold increase in hand-washing compliance, the group noted that 559 of its surveyed hospitals did not meet its bar and are “potentially exposing hundreds of thousands of patients to preventable risk.” It also acknowledged “gaps in compliance” even among those who achieved its standard.
The report outlines other specific areas of improvement among the surveyed hospitals. Within the culture domain, for instance, 99.3% of hospitals said their CEO, chief medical officer and chief nursing officer had demonstrated a commitment to hand hygiene to front-line staff within the past year.
The portion of hospitals providing hand hygiene compliance data to leaders, and then holding leadership accountable for performance through reviews or compensation, grew from 48.6% to 86.3% from 2020 to 2023.
To ensure compliance, the percentage of hospitals that said they use hand hygiene coaches or compliance officers to improve adherence rose from 58.7% in 2020 to 92.4% in 2023.
Adoption of electronic compliance monitoring technologies more than doubled during the period but still remain relatively low at 10%. Still, “this growth demonstrates a broader trend toward integrating advanced tools to address the limitations of human observer,” Leapfrog wrote in an accompanying release.
Though substantially less common, Leapfrog’s report bemoaned that about 14% of respondents, or 307 hospitals, still don’t require workers to physically demonstrate proper hand hygiene technique to pass initial training. Meanwhile, 96.3% of hospitals said they have processes to ensure supplies are available to workers, while 90.5% conduct audits to ensure the proper amount of hand sanitizer is being dispensed.
“Leapfrog will continue to publicly report each hospital’s performance and uphold the highest possible standards for excellence,” Leah Binder, president and CEO of The Leapfrog Group, said in a statement. “We believe transparency and high standards truly galvanize change, and we are proud to recognize the hospital leaders, clinicians, and teams that so successfully make that change.”
Hand-washing is a core component of hospitals’ infection control strategies and can bring direct cost savings alongside a reduction in preventable patient harm.
Leapfrog’s spring release of its broader Hospital Safety Grades has pointed to gains on hospital infections as well as patient experience measures. Meanwhile, a summer update from the Centers for Disease Control and Prevention had noted a rise in antibiotic-resistant hospital infections since 2019—though the agency’s data set from PINC-AI Healthcare Database and the BD Insights Research Database only ran through 2022.