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New Monograph on Hand Hygiene May Push Us Forward -- by Suzanne Delbanco, Ph.D.

Hand hygiene The Joint Commission, along with several partners, has just released a new framework for determining "when, why and how to measure compliance with hand hygiene."  The monograph, entitled Measuring Hand Hygiene Adherence: Overcoming the Challenges, is the result of a two-year collaboration among the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), the Centers for Disease Control and Prevention (CDC), the Society for Healthcare Epidemiology of America (SHEA), the World Health Organization (WHO) World Alliance for Patient Safety, the Institute for Healthcare Improvement (IHI) and the National Foundation for Infectious Diseases (NFID).

What's the big deal?  There has yet to be agreement about how to measure compliance with hand hygiene protocols. Without some standardization, it is very difficult to measure the comparative effectiveness of different interventions to improve and sustain hand hygiene practices.  And depending on the measurement method, hospitals may produce for themselves a false sense of security that their hand hygiene practices are sufficient when they are not.  My suspicion is that the more rigorously we measure hand hygiene practices, the more disappointed we will be with performance - that is, until we also implement successful interventions to drive and maintain improvement.

The monograph does not create a single international standard for measurement of hand hygiene practices, though it draws from examples from several countries.  It moves us closer, however.  So let's cross fingers and get to the hard work ahead.

At Arrowsight, we offer a powerful methodology for implementing many of the features and elements of measurement the monograph outlines.  Arrowsight's deep experience in video monitoring and feedback in other industries allowed us to jump start our efforts in health care.  Our work is too new to have been cited in the monograph, though we have recently briefed many of its authors.  With 24/7 video monitoring, a very large and continuous sampling process, rigorous quality assurance and near-real-time feedback to front-line staff, we are excited for our Hospital Video Auditing approach to be part of the solution going forward. 

As a side note, it may not be a surprise to readers that the project was underwritten by GOJO Industries, the makers of Purell hand sanitizer.

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