5% Of Your Clinicians Are Creating Up To 40% Of Your Hand Hygiene Risk

By Chris Hermann

Did you know that 5% of your clinicians are causing between 25% and 40% of your hand hygiene problem? We analyzed over 60 million hand hygiene data points from hospitals all over the country. Starting out, the bottom 5% of clinicians make up 25% of all missed hand hygiene opportunities. This percentage quickly climbs to over 40% in some cases, as overall hand hygiene performance improves among the other 95%.

We’ve seen this pattern over and over – it’s always a minority of providers that are failing to clean their hands and make up the vast majority of the risk for an organization. These missed opportunities are the low hanging fruit in terms of increasing hand hygiene performance, which, of course, leads to reducing healthcare-associated infections (HAIs).

This matters more now than it ever has. The Joint Commission recently raised the standards for hand hygiene, and, as of January 1, clinicians have to perform hand hygiene every time or risk a citation. So it’s imperative to identify the clinicians that are disproportionately responsible for endangering not only patients, but the hospital’s accreditation.

While Direct Observation is still used in the majority of hospitals, it won’t help you when it comes time for The Joint Commission visit. Because Direct Observation is hugely susceptible to the Hawthorne Effect, all it can do is provide you a false sense of security. To further compound this – even if you happen to get lucky and find someone who is a problem, you can’t fix it with Direct Observation.

In order to improve hand hygiene to the point where you avoid a citation and reduce HAIs, your organization needs to embrace a comprehensive data collection strategy, a systematic and engaging process to improve everyone’s performance, and a data-driven approach to identify and address underperformers.

This is easily done with electronic hand hygiene reminder systems that can recognize individuals. Not all technology can do this – some systems are limited to just aggregate data of the entire group, making it impossible to identify lower-performing people. But systems that track individual data can pinpoint the 5% of providers that are putting patients and your hospital at risk.

Once you’ve identified those individuals, then what? We never recommend a punitive approach. Clinicians are hardworking, well educated, highly compassionate people. Believe it or not, most of the time they fail to clean their hands really isn’t their fault! (Read The Top 5 Real (and Surprising) Reasons Clinicians Don’t Clean Their Hands.)

The fastest way to improve hand hygiene and keep The Joint Commission from issuing a citation is to identify the 5% of individuals that are pulling down overall performance and work with them in a positive way to change their behavior.

If you’d like to explore how our system typically doubles hand hygiene performance rates, here’s a brief video about how it works, and here’s a white paper on our process of continual, positive behavior change.


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