Beyond Hand Hygiene Compliance

The evidence is in: a decade of hospital hand hygiene compliance has failed to significantly reduce infection rates. We know this because high-quality, peer-reviewed analyses tell us so.*

We all know that clean hands matter a lot. So why is a singular focus on hand hygiene compliance a failure? Our work shows three main reasons.

First, measuring compliance does nothing to improve it, and campaigns to improve it only work for a few weeks until old habits return.

Second, the WHO’s “Five Moments” are incomplete (why aren’t hospital staff asked to wash their hands after they go to the bathroom, and why are there no guidelines for patient hand hygiene?).

Third, the money spent on compliance measurement comes at the expense of the effort that is needed to understand hand hygiene as a complex social and situational phenomenon.

We do world-leading clinical engagement and research to go beyond hand hygiene compliance by answering ‘when’, ‘where’, and ‘why’ questions of hand hygiene. We use state-of-the-art electronic tools and cognitive/behavioral measures. And what we have found is astounding.

Instead of low-compliance staff, we see low compliance rooms. We see visitors and patients not given the motivation and the means to clean their hands. We see staff subcultures that can undermine patient safety.

Measuring compliance is no way to understand the real problem. Want to know more?


* DiDiodato G. (2013). Has improved hand hygiene compliance reduced the risk of hospital-acquired infections among hospitalized patients in Ontario? Analysis of publicly reported patient safety data from 2008 to 2011. Infection Control and Hospital Epidemiology, 34(6):605-10

*Gould DJ, Moralejo D, Drey N, Chudleigh JH. (2010). Interventions to improve hand hygiene compliance in patient Care. The Cochrane Library, Issue 9.

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The Business Case for Patient Safety

Do you understand the true cost hospital infections?

Can you present the case for greater investment in prevention and control at your hospital?

With some simple information you already have at hand – we can help.

Hospital infections compromise not only patient safety, but your facility’s financial health and reputation.

The motivations for preventing infections are multiple – including raising HCAHPS scores, reducing readmissions, and preventing line and surgical site infections. These all contribute to increased financial penalties from HRRP and HAC.

But there is good news too: incentives and rewards for preventing infections continue to increase.

We can help you understand your current financial burden from avoidable infections, while demonstrating the turnaround you can achieve through eliminating penalties and increasing pay-for-performance.

To learn more about our solutions and making the business case for patient safety, please contact us.