title: Implementation and impact of an automated group monitoring and feedback system to promote hand hygiene among health care personnel.
abstract: BACKGROUND
  Despite substantial evidence to support the effectiveness of hand hygiene for preventing health care-associated infections, hand hygiene practice is often inadequate. Hand hygiene product dispensers that can electronically capture hand hygiene events have the potential to improve hand hygiene performance. A study on an automated group monitoring and feedback system was implemented from January 2012 through March 2013 at a 140-bed community hospital.
  
  
  METHODS
  An electronic system that monitors the use of sanitizer and soap but does not identify individual health care personnel was used to calculate hand hygiene events per patient-hour for each of eight inpatient units and hand hygiene events per patient-visit for the six outpatient units. Hand hygiene was monitored but feedback was not provided during a six-month baseline period and three-month rollout period. During the rollout, focus groups were conducted to determine preferences for feedback frequency and format. During the six-month intervention period, graphical reports were e-mailed monthly to all managers and administrators, and focus groups were repeated.
  
  
  RESULTS
  After the feedback began, hand hygiene increased on average by 0.17 events/patient-hour in inpatient units (interquartile range = 0.14, p = .008). In outpatient units, hand hygiene performance did not change significantly. A variety of challenges were encountered, including obtaining accurate census and staffing data, engendering confidence in the system, disseminating information in the reports, and using the data to drive improvement.
  
  
  CONCLUSIONS
  Feedback via an automated system was associated with improved hand hygiene performance in the short-term.
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Conway
authors.forename: Linda
authors.initials: L
authors.lastname: Riley
authors.forename: Lisa
authors.initials: L
authors.lastname: Saiman
authors.forename: Bevin
authors.initials: B
authors.lastname: Cohen
authors.forename: Paul
authors.initials: P
authors.lastname: Alper
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Larson
mesh_terms: D003428:Cross Infection / Q000517:prevention & control; D005246:Feedback; D017144:Focus Groups; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006235:Hand Disinfection; D063373:Hand Hygiene / Q000706:statistics & numerical data*; D006744:Hospital Bed Capacity, 100 to 299; D006748:Hospital Departments; D006764:Hospitals, Community / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control / Q000379:methods*; D010564:Personnel, Hospital; D017410:Practice Guidelines as Topic