title: Achieving Hand Hygiene Success With a Partnership Between Graduate Medical Education, Hospital Leadership, and Physicians.
abstract: Engaging physicians in hand hygiene programs is a challenge faced by many academic medical centers. Partnerships between education and academic leaders present opportunities for effective collaboration and improvement. The authors developed a robust hand hygiene quality improvement program, with attention to rapid-cycle improvements, including all levels of staff and health care providers. The program included a defined governance structure, clear data collection process, educational interventions, rapid-cycle improvements, and financial incentive for staff and physicians (including residents and fellows). Outcomes were measured on patients in all clinical areas. Run charts were used to document compliance in aggregate and by subgroups throughout the project duration. Institutional targets were achieved and then exceeded, with sustained hand hygiene compliance >90%. Physician compliance lagged behind aggregate compliance but ultimately was sustained at a level exceeding the target. Successfully achieving the institutional goal required collaboration among all stakeholders. Physician-specific data and physician champions were essential to drive improvement.
authors.affiliation: University of California, San Francisco, CA rosenbluthg@peds.ucsf.edu.
authors.forename: Glenn
authors.initials: G
authors.lastname: Rosenbluth
authors.affiliation: UCSF Medical Center, San Francisco, CA.
authors.forename: Susan
authors.initials: S
authors.lastname: Garritson
authors.affiliation: University of California, San Francisco, CA.
authors.forename: Adrienne L
authors.initials: AL
authors.lastname: Green
authors.affiliation: University of California, San Francisco, CA.
authors.forename: Dimiter
authors.initials: D
authors.lastname: Milev
authors.affiliation: Duke-NUS Graduate Medical School, Singapore.|Singapore General Hospital, Singapore.
authors.forename: Arpana R
authors.initials: AR
authors.lastname: Vidyarthi
authors.affiliation: University of California, San Francisco, CA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Auerbach
authors.affiliation: University of California, San Francisco, CA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Baron
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration* / Q000592:standards; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D063373:Hand Hygiene / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration / Q000592:standards; D007400:Interprofessional Relations; D009042:Motivation; D010820:Physicians / Q000458:organization & administration* / Q000592:standards; D058996:Quality Improvement / Q000458:organization & administration
keywords: hand hygiene; infection control; quality improvement; residents and fellows