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Boosting hand-hygiene rates

Just don't use the word "compliance"

November 2017

CHRIS HERMANN, PhD, still laughs about his response 11 years ago when an intensivist told him that hospitals could really use some technology to help improve hand hygiene.

At the time, Dr. Hermann was a dual MD/PhD (in bioengineering) candidate at Emory School of Medicine and Georgia Tech, both in Atlanta. His response—”That should be simple enough”—kicked off years of research, more than $5 million in federal and state grants, and a host of research partnerships, including one with the CDC.

While the task turned out to not be simple at all, it did lead to the launch of the company that grew out of that research: Clean Hands Safe Hands, with Dr. Hermann as founder and CEO. (He did receive his PhD and plans to graduate with his MD in May 2018.) The system, which relies on sensors attached to soap or sanitizer dispensers and to clinician staff badges, features several improvements over early hand-hygiene technology.

The biggest driver for improving hand hygiene turns out to be a voice reminder.

For one, the system doesn’t make providers do anything—like having to stop and swipe a badge when entering or leaving a patient’s room—that changes their workflow. It also relies on a voice reminder to let clinicians know in real time that they need to wash or sanitize if they forget to do so.

“That’s the biggest driver for improving hand hygiene,” Dr. Hermann says. “We find that a voice reminder is the single most important way to get clinicians’ attention.”

The sensors and natural-voice reminder drive a six-phase implementation program that takes between nine and 12 months for hospitals that install the Clean Hand Safe Hands system to complete. One phase is working with clients’ chief quality officer or their epidemiology or patient safety leadership to set up competitions—between doctors and nurses or day vs. night teams—to further spur change.

That makes improvement fun and rewarding, Dr. Hermann points out, while giving hospitals the ability to identify who may be struggling and what further interventions may be needed. He adds that hospitals using the system can double or even triple their rates of handwashing compliance.

That brings up another lesson learned: Never use the word “compliance” (or “monitoring,” for that matter).

” ‘Compliance’ is a dirty word that clinicians get very defensive about,” Dr. Hermann says. “Instead, we use ‘performance,” which includes the concept of improvement. We’re not here to monitor a problem but to drive behavior change.” For more information, see Clean Hands Safe Hands.



Published in the November 2017 issue of Today’s Hospitalist
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