Bucking the Status Quo to Reduce HAIs

By Clean Hands - Safe Hands

There are no quick fixes for Hospital Acquired Infections (HAIs). Hand hygiene is the cornerstone for reducing HAIs, but improving those practices is not an easy task for hospitals, especially for those that continue to use traditional methods. The importance of hand hygiene was established over 170 years ago—yet, in many respects, we keep trying the same things without much success. Sometimes you have to let go of the status quo.

Currently, the most common approach to reducing hand hygiene infection is direct observation.  Once considered the gold standard, this approach consists of observing the behaviors of fellow clinicians to evaluate their performance when it comes to hand washing and sanitizing.

It doesn’t work.

Eleven years ago in Atlanta, a consortium of technologists and clinicians banded together to discover something that does. That’s how our company was born.

In our reenergized blog, we’ll be discussing a range of HAI prevention approaches and issues. For this first entry, I’d like to tell you a little about our approach, and why it is working for hospitals who want a new way to tame the beast of Hospital Acquired Infections.

Direct observation doesn’t cut it

Research has shown as many as a dozen reasons direct observation is inaccurate and inadequate. I won’t go into all of them here, but the most important one is the Hawthorne Effect. Named after one of the most famous experiments in industrial history—at a Western Electric factory outside Chicago in the early part of the 20th century—it established the concept of observation bias, where those being observed tend to perform better under observation. In the hospital setting, it means the mere presence of a direct observer prompts clinicians to wash their hands. Unfortunately, this presents a distorted view of hand washing practices in hospitals.

There are several studies showing dramatic variations between hand hygiene compliance under direct observation and electronic monitoring. Hospitals using direct observation reported compliance of 90 percent based on fewer than 100 monthly observations. Compare that to electronic monitoring, which measured only 30 percent or less compliance based on 50,000+ observations.

One would think that electronic monitoring technology is the key to improving hand hygiene performance in hospitals. At CHSH, we agree, but it’s only the beginning. Tackling the problem of HAIs requires going beyond monitoring. It requires changing the behavior of clinicians.

A personal-best approach

Hand hygiene monitoring technology is like a thermometer. It can tell you when patients are sick, but it doesn’t offer any way to help them get better. That’s how we’re different at Clean Hands – Safe Hands, and the interest we’re drawing from hospitals across the country is exhilarating. We not only have best-in-class technology that documents hand hygiene performance in hospitals, but we also partner with hospitals to leverage this technology through a systematic process to help improve their performance.

Our solution focuses on improving clinician behavior without disrupting it. We identify individual provider data through a small, lightweight badge reel that allows us to record very accurate data without getting in the way of patient care. Our customized program allows us to match your unique policies and workflow down to the level of individual patients. As long as providers are cleaning their hands appropriately, our system is completely invisible. Our sensors also provide a gentle, non-disruptive voice reminder only when staff members forget. The voice reminder is the biggest driver that leads to improved performance and patient engagement—and we are the only company that provides it.

The journey to better HH performance

The data is the starting point for a systematic process that transforms hand hygiene programs. By nurturing a culture of fun and positive competitions at the group and the individual level, we start hospitals on a journey that is proven to stop infection problems at their source.

And it is a journey. Hospital leaders who understand that—and are willing to partner with us on the journey—are finding success. Our hospital partners have achieved such milestones as a 75 percent reduction in HAIs in the ICU, an 80 percent reduction in C. Diff (with net savings of $1 million) and 300 percent improvement following implementation of our patented voice reminder technology.

These hospitals know there is no quick fix; success in reducing HAIs won’t happen overnight. They understand the limits of direct observation, and they have made the commitment to go beyond simply recording data to improving the safety of their patients.


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