Impact of a Successful Speaking Up Program on Health-Care Worker Hand Hygiene Behavior

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Infection Prevention

Background:

• Health-care worker (HCW) hand hygiene (HH) is critical for reducing hospital infections but compliance rates are often low.
• Real-time mitigation strategies can improve HH reliability to over 95%, but implementation has been challenging.

Purpose of the Study:

• To achieve and sustain health-care worker (HCW) hand hygiene (HH) compliance rates exceeding 95%.

Main Methods:

• A hospital-wide quality improvement initiative was implemented, measuring HH through covert direct observation.
• Interventions included leadership support, knowledge enhancement, supply availability, and culture change.
• The

Main Results:

• Over 30,000 HH observations were conducted between 2012 and 2016.
• HCW HH compliance increased from 75% to over 90% by December 2014.
• Following the

Conclusions:

• A structured process empowering staff to address HH failures is key to sustainable HH improvement.
• Multimodal improvement efforts, combined with real-time failure mitigation, can achieve and maintain HH rates above 95%.