“You can’t change someone’s behavior before you understand it and so I began my research phase by observing the nurses, whose behavior I hoped to change, and the Infection Prevention and Control staff, who wanted me to change the behavior. At a well-attended meeting with leaders from multiple departments, I presented a provocation. I wanted those who control the dialogue and data around hand hygiene to feel what consistent hand hygiene compliance was like.”

“Many non-quantifiable factors affect hand-hygiene comliance rates: “a nurse’s personal habits, the unit’s spatial layout, its speciality and leadership, etc. all affect the disease of non-compliance and each needs to be taken into consideration when formulating a plan of action. As with most longstanding problems, if a singular solution existed then we would have solved it already.”

The bottom line is that hand hygiene is important. We recognize that it isn’t easy but if we work together to continue improving, we know we can make a positive difference.

“Hospital staff, with all of their limitations, are drawn to creative solutions. Their need to satisfy patients, superiors and protocols for 12 hour shifts require regular feats of physical gymnastics. Not only are these feats going unacknowledged but they are also going unstudied. In a society driven by sight, our own physical behaviors are under examined and under designed. For me, physical behaviors frame the problem, research and solution. Rather than creating systems to observe or remind people to strive for nearly impossible goals in a poorly designed environment, designers need to grapple with all the good reasons why health care workers aren’t sanitizing their hands and look to the staff for solutions. Patients and health care workers deserve more from design.”

On the surface, hand hygiene compliance seems simple. However, compelling compliance is not a lack of desire on the healthcare worker’s part, but rather a work-flow issue. Proventix is working hard to further understand these issues and to create systems that improve compliance and create healthcare worker efficiency.

The hospital reduced confirmed healthcare-associated infections by 75 percent from 2010 to 2011 after initiating a clean-hands program to monitor and improve hand hygiene based on nGage technology. The employees’ compliance efforts have equated a $42,600 cost savings and a 48.4-day decrease in incremental length of stay.

Read more at Andalusia Star News

Hospitals have experienced an average 105.6% increase in hand hygiene solution dispenses since implementation of the Proventix monitoring system. This improvement in hand hygiene activity has contributed to an average healthcare associated infection (HAI) reduction of over 24% across all Proventix monitored units.

Proventix’s growth demonstrates acceleration in the application of low cost Radio Frequency Identification (RFID) devices for quality based monitoring solutions. Proventix provides active and passive RFID devices and services for quality compliance monitoring and active point of care communication for successful integration into operations.

Read more at Infection Control Today.

“Consistency and frequency are the true engines of improvement. If you know a behavior will make a difference, you’ll want to practice it every day with every patient—just as you provide medication consistently and at a certain frequency. When you’re sure this is happening, and that people aren’t taking a hit-or-miss approach, you should see the numbers begin to climb.”

“But what really drives people is the realization that by adopting and hardwiring a particular best practice they’re not just moving numbers up. They’re saving lives. When we can remember that, and communicate it regularly to those we work with, we tap into their passion and sense of purpose—and once we do that, we can do anything.”

More Insights from Studer Group Experts.

Yet something as simple as strict hand hygiene can prevent infections. In the September issue of the journal Health Affairs, for example, University of North Carolina researchers describe changes in the North Carolina Children’s Hospital pediatric intensive care unit. Simply attaching hand sanitizer dispensers to the walls outside patients’ rooms and implementing a few low-cost preventive measures shortened hospital stays more than two days on average, reduced hospitalization costs by more than $12,000 per case and cut death rates by 2.3%.

The guide sites two examples:

The Washington State Hospital Association (WSHA) conducts an annual CEO and Trustee Patient Safety Summit. During this meeting, board members are able to learn about board leadership in patient safety from national experts. They discuss how to ask questions about sometimes complex clinical reports to advance quality in their hospitals. Engaging hospital leaders has resulted in a significant shift in the way hospital boards operate, which WSHA has monitored for four consecutive years through a survey.

As another example, the South Carolina Hospital Association (SCHA) created Best on Boards, a voluntary, evidence-based board certification program for hospital trustees and senior hospital leaders. The program has been designed around the governance core competencies identified and published in the AHA’s Blue Ribbon Panel on Health Care Governance report.

According to the guide, “Many allied hospital associations understand that organizational change needs senior-level leadership support to be successful, and they have developed educational programs and tools to ensure this commitment.”

“As agents of change start to convince more and more people, the situation begins to change,” Sreenivasan adds. “People begin to question their own views at first and then completely adopt the new view to spread it even further. If the true believers just influenced their neighbors, that wouldn’t change anything within the larger system, as we saw with percentages less than 10.”

This research can easily be applied to the healthcare industry, and hand hygiene practices in particular, when a culture of change is adopted by “true believers”.
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Based on the results, Princeton Baptist expanded the technology from the post-surgical unit to other parts of the hospital. “We’ve been on multiple floors and we’re staying on average across those floors in the mid 20% range [of infection reductions]. There was enough savings on two floors to cover the cost of the system across the whole hospital,” said Proventix CEO, Harvey Nix.

It is predicted that all of Princeton Baptist will be using the Proventix system by the end of 2011.  Administrators are also looking to expand their use of the device’s other communication features.

“We’re just getting to the point of integrating two-way communication on it, so that they’re able to use the screen to provide feedback and get feedback about the patient that they are about to take care of,” said Mr. Nix. For example, a device could be set to warn anyone washing his hands outside a particular patient’s room that the patient is under isolation precautions.

Read the full article from the July issue of ACP Hospitalist.