Multi-Facility Reduction in Hospital-Acquired Infections (HAIs) Through Real-Time Feedback and Individual Accountability

Abstract

Background: Hospital-acquired infections (HAIs) are a leading cause of healthcare morbidity and cost for the health community. It is widely recognized that hand hygiene is the leading contributor infections, but hand hygiene still remains a major problem for nearly all healthcare systems. A longitudinal study was conducted over a 4-year period in a community-based health system. Methods: An electronic hand hygiene reminder system was installed in 2 different facilities including both critical care and noncritical units. This system collects data on individual healthcare provider hand hygiene and provides a real-time voice reminder in the event that a provider forgets to perform hand hygiene. The primary study was designed to investigate the impact of a real-time voice reminder to improve hand hygiene. A baseline period of hand hygiene was established prior to the interventions after installing the system without any access to data reporting or the voice reminder. Each of the hospitals had the voice reminder turned on and off 3 times. The baseline HAI rates were established by comparing in each facility for the 12 months prior to the implementation of the system. During the study period, there were no significant changes to other common infection control practices. Results: In both facilities, every time the voices were turned on, hand hygiene improved significantly and each clinical unit saw a >200% improvement in hand hygiene within 3 months of turning the voice reminder. HAIs fell by a statistically significant in all clinical areas by 51%. After a period of stabilization, the voice reminder was turned off hand hygiene compliance fell and HAI rates then increased. The voice reminder was then turned back on and off 2 more times. In every case, hand hygiene rates fell back to the baseline and HAIs returned to their baseline. When the voice reminder was then turned back on, HAIs dropped to 54%–81% of the baseline in each of the clinical units. The system also captured individual providers’ hand hygiene performance data and displayed it in a simple and engaging way, allowing managers easily understand who was struggling with hand hygiene. These data were then leveraged through a series of competitions to systematically drive hand hygiene performance improvement. These included traditional interventions to address an education issue in addition to interventions to identify workflow problems. Conclusions: Using this highly targeted approach, the leadership were able to efficiently drive sustained hand hygiene improvement and a further reduction in HAIs.Funding: NoneDisclosures: None