All hands on deck: improving medical staff compliance with hand hygiene

Abstract

Introduction: The results from Hand Hygiene Australia demonstrate medical staff compliance with hand hygiene (HH) is below that of other disciplines. In a tertiary hospital in Western Australia a junior doctor completed a 10 week Clinical Service Redesign project, focusing on improving HH compliance amongst medical staff at the institution. Method: A Clinical Service Redesign framework was used that included the principles and methodologies of Lean Six Sigma. Consultation occurred with doctors of all levels. A root cause analysis was undertaken and contributing factors to poor HH compliance were identified. Following this, “solutions” sessions were held to address the issues identified. Results: The root causes identified included themes such as a lack of Consultant leadership, poor personal HH (including that HH is not a habit for doctors) and ward round logistics often being prohibitive to HH. The solutions included: • Designing a suitable trolley for use on the ward round. • Auditing HH on the ward rounds by a credentialed hand hygiene auditor with results published in a ‘leader board’ fashion. • Engaging senior doctors in each department to ‘champion’ HH and be responsible for reacting to leader board results. • Developing visual ‘Remind Me!’ prompts to be worn intermittently by medical staff to encourage healthcare workers from all levels to perform HH. Conclusion: The solutions continue to be implemented and the lessons learnt will be presented. Regular re-auditing continues to monitor the success of the interventions. Engagement of the medical staff in HH has been invaluable in the project.