title: Costing the Australian National Hand Hygiene Initiative.
abstract: BACKGROUND
  The Australian National Hand Hygiene Initiative (NHHI) is a major patient safety programme co-ordinated by Hand Hygiene Australia (HHA) and funded by the Australian Commission for Safety and Quality in Health Care. The annual costs of running this programme need to be understood to know the cost-effectiveness of a decision to sustain it as part of health services.
  
  
  OBJECTIVE
  To estimate the annual health services cost of running the NHHI; the set-up costs are excluded.
  
  
  METHODS
  A health services perspective was adopted for the costing and collected data from the 50 largest public hospitals in Australia that implemented the initiative, covering all states and territories. The costs of HHA, the costs to the state-level infection-prevention groups, the costs incurred by each acute hospital, and the costs for additional alcohol-based hand rub are all included.
  
  
  RESULTS
  The programme cost AU$5.56 million each year (US$5.76, £3.63 million). Most of the cost is incurred at the hospital level (65%) and arose from the extra time taken for auditing hand hygiene compliance and doing education and training. On average, each infection control practitioner spent 5h per week on the NHHI, and the running cost per annum to their hospital was approximately AU$120,000 in 2012 (US$124,000, £78,000).
  
  
  CONCLUSIONS
  Good estimates of the total costs of this programme are fundamental to understanding the cost-effectiveness of implementing the NHHI. This paper reports transparent costing methods, and the results include their uncertainty.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia. Electronic address: katie.page@qut.edu.au.
authors.forename: K
authors.initials: K
authors.lastname: Page
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: A G
authors.initials: AG
authors.lastname: Barnett
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Campbell
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Brain
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Martin
authors.affiliation: King's College, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Fulop
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia; Centre for Healthcare Related Infection Surveillance and Prevention, Queensland Health, Herston, Queensland, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Graves
mesh_terms: D001315:Australia; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000517:prevention & control*; D006235:Hand Disinfection; D063373:Hand Hygiene; D006779:Hospitals, Public / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control / Q000191:economics*; D061214:Patient Safety / Q000191:economics*
keywords: Costs; Economics; Hand hygiene; Infection control