Carol Mangles, RN, BSN, CIC, infection prevention and control supervisor at Barnes Jewish St. Peters Hospital, reports that at her 100-bed community hospital that is part of large BJC system, they had struggled with hand hygiene compliance rates stagnating in the 80 percent range. “In late 2007, a decision was made to begin collecting the names of the compliant and noncompliant healthcare workers who were observed that month,” Mangles says. “We typically collect 120 to 200 hand hygiene observations each month from our inpatient units, emergency department, and pre-op/post-op areas. To soften the idea of collecting names, we developed the Hand Hygiene Hero (HHH) award program beginning in February 2008. Monthly, in the cafeteria during lunch time, the names of one to three compliant healthcare workers during the previous month are drawn to win a monetary gift. We also post their photos on a screensaver that is sent out to all hospital computers, and we post the printed photos on our HHH bulletin board outside our cafeteria. Their names also go into our monthly newsletter. These activities help keep hand hygiene in healthcare workers’ minds and reward our compliant ones. The names of the noncompliant healthcare workers are forwarded to the appropriate manager for discussion and re-education. Physicians and LIPs are also included. Noncompliant LIPs are forwarded to the credentialing committee. Compliant LIPs are also noted on their individual quality reports. Our observers who are collecting the hand hygiene observations are also handing out ‘You have been spotted!’ cards; we have a noncompliant card and a compliant card (it’s good for a $2 treat in the cafeteria). After making these changes, we have seen our monthly compliance score increase to the mid-90s. We ended our year-end (2008) rate at 93 percent.”
In late 2007, Tufts Medical Center was committed to improving its less-than-satisfactory hand hygiene compliance rate of 71 percent. The obvious risks to patient safety, along with an impending visit by the Joint Commission, led Tufts to launch a comprehensive hand hygiene program in March 2008. The hospital had tried smaller, generic, uncoordinated programs in the past with little success. A coordinated, consistent effort was need to add to the strong commitment of the senior medical leadership. A creative, unique approach was necessary to cut through the clutter. Working together, Tufts Medical Center and Jennings Co., healthcare marketing firm, created the Speak Up Wash Up hand hygiene campaign, according to Dan Dunlop, president of Jennings Co.
“We designed the Speak Up, Wash Up campaign to blanket the hospital while providing fun and informational messaging,” Dunlop explains. “Using a speach bubble theme, we created a culture that was lively and fun. At the same time, we empowered everyone in the hospital to speak up and promote hand hygiene to each other. By keeping hand hygiene fun and top of mind, compliance was easier to promote.”
Speak Up Wash Up collateral material included: