Beyond the collaborative: spreading effective improvement in hand hygiene compliance

Area of Science:

• Healthcare Quality Improvement
• Infection Control
• Patient Safety

Background:

• Effectiveness of quality improvement (QI) collaboratives is debated, with challenges in spreading improvements beyond initial participants.
• Limited understanding exists on non-participant organizations' ability to adopt interventions from collaborative initiatives.

Purpose of the Study:

• To assess the effectiveness of a Web-based tool (Targeted Solutions Tool® - TST®) in enabling healthcare organizations to improve hand hygiene compliance.
• To determine if organizations not part of the original QI collaborative could achieve similar improvements using the TST.

Main Methods:

• A collaborative QI project involving eight hospitals used Lean, Six Sigma, and change management to enhance hand hygiene.
• Developed a Web-based tool (TST®) to guide organizations in identifying and addressing causes of noncompliance without prior QI expertise.
• The TST was implemented across 289 healthcare organizations.

Main Results:

• The initial collaborative achieved a 70.5% relative improvement in hand hygiene compliance.
• Organizations using the TST initiated 1,495 hand hygiene projects.
• Average hand hygiene compliance improved from 57.9% to 83.5% across 174 organizations using the TST.

Conclusions:

• Healthcare organizations utilizing the TST achieved hand hygiene compliance levels comparable to those in the original collaborative.
• The TST effectively disseminated QI methods, enabling widespread improvement in hand hygiene practices across diverse clinical settings.