title: Impact of a mandated provincial hand hygiene program: messages from the field.
abstract: BACKGROUND
  The British Columbia Provincial Hand Hygiene Working Group was formed in September 2010 and tasked with the development and implementation of a provincial hand hygiene (HH) program for health care.
  
  
  METHODS
  As part of an evaluation of the provincial HH program, qualitative key informant interviews of program developers, senior administrators, and field workers were performed from December 2011 to March 2012 (phase 1) and again in April to June 2013 (phase 2).
  
  
  RESULTS
  The following 5 broad themes were identified: (1) the provincial HH program became a platform for cooperation; (2) standardization (of HH audits and program components) strengthened and provided credibility to the provincial HH program; (3) quality results and good communication enabled a learning process that resulted in positive change management; (4) with ownership came pride and program success; and (5) management support and infrastructure is needed to sustain a positive culture change.
  
  
  CONCLUSIONS
  Positive behavior change for HH can be achieved on a provincial scale through a program that is standardized, has mandated components, is well communicated, owned by the frontline workers, and receives sustained support from senior management.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of British Columbia; Provincial Infection Control Network, British Columbia. Electronic address: Elizabeth.Bryce@vch.ca.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bryce
authors.affiliation: University of British Columbia, Canada.
authors.forename: Saiful
authors.initials: S
authors.lastname: Islam
authors.affiliation: Department of Social Medicine and Global Health, Lund University, Sweden.
authors.forename: Becky
authors.initials: B
authors.lastname: Nelson
authors.affiliation: Provincial Infection Control Network, British Columbia.
authors.forename: Bruce
authors.initials: B
authors.lastname: Gamage
authors.affiliation: University of British Columbia, Canada.
authors.forename: Robin
authors.initials: R
authors.lastname: Wilson
authors.affiliation: Fraser Health Authority, British Columbia.
authors.forename: Petra
authors.initials: P
authors.lastname: Welsh
authors.affiliation: Provincial Infection Control Network, British Columbia.
authors.forename: Guanghong
authors.initials: G
authors.lastname: Han
mesh_terms: D001955:British Columbia; D003428:Cross Infection / Q000517:prevention & control*; D063373:Hand Hygiene / Q000379:methods*; D006291:Health Policy; D006302:Health Services Research; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000458:organization & administration*; D007407:Interviews as Topic
keywords: Hand hygiene; Safety culture