When patients walk into a hospital, they should expect quality care, not the possibility of contracting a preventable healthcare-associated infection (HAI). Challenges with hand hygiene compliance and HAIs in hospitals have existed since the beginning of modern medicine and the statistics aren’t getting any better:
To reduce HAIs, the Centers for Medicare and Medicaid (CMS) publishes an annual list of hospital acquired conditions (HAC) along with the bottom 25% of hospitals. If a hospital is on the HAC list, they are subject to losing millions of dollars in non-reimbursable care.
The Problem- Sustaining Compliance
It is widely known that proper hand hygiene is foundational to prevent HAIs. Hospitals have tried various programs and educational campaigns that don’t enable the sustainable behavior change required for success. For decades, manual observation was considered the primary method for measuring hand hygiene compliance. This method has many limitations – including bias (Hawthrone effect) and inadequate sample sizes projecting an inaccurate compliance picture.
The Joint Commission recently weighed in, dramatically shifting their position by issuing a stern warning regarding improper hand hygiene:
“Effective January 1, 2018, for all accreditation programs, any observation by surveyors of individual failure to perform hand hygiene in the process of direct patient care will be cited as a deficiency resulting in a Requirement for Improvement…”.
Electronic Hand Hygiene Monitoring
The answer to this problem is electronic hand hygiene monitoring, but not all solutions are created equal. Solutions claim reduced HAI’s and increased compliance, but nowhere near a sustained level of 97+%. The average compliance rate for most solutions is between 70-80% because metrics are based on clever algorithms associated with the amount of soap and sanitizer dispensed, or there is no point of care behavior modification.