Thursday, December 11, 2014

How Did We Improve Our Hand Hygiene Rates?

I arrived at GBMC in the summer of 2010 shortly after we received our first “secret shopper” measurement of hand hygiene and learned that it was a toss-up if someone coming into your daughter’s room at GBMC had washed his or her hands before entering. I remember thinking that it wasn’t that people didn’t know to wash their hands nor was it that they didn’t care. The rate was only about 50% because people’s minds were elsewhere…they were busy or they were distracted. I wondered how we would ever get closer to clean hands every time? I couldn’t think of a design change that was likely to work.

We tried the “technology” route in the MICU. We worked with a vendor that had software that would measure the rate and prompt the individual. We ended the test concluding that the MICU rate was no better than rates without the technology. We started to get traction when units started doing audits on a few trips in and out of a room on a daily basis. It seems that the staff doing audits generated better engagement and it started to lock in the habit.

Our run chart of hand hygiene compliance is one of the best examples of healthcare improvement that I have ever seen. I am still reflecting on the drivers of this change so I asked some GBMC colleagues. More awareness and people looking out for each other…measuring on a unit LDM board…extra focus…spreading knowledge about hand hygiene….culture change…the realization that we were not washing our hands….making it more personal for you…. turning handwashing into a fun game….calling it out among colleagues….these are the reasons my colleagues listed for this great improvement. The rate of almost every hospital acquired infection that we measure has been reduced as our hands have been getting cleaner. I am very grateful to all of my GBMC colleagues for this improvement work.

I would love to hear your ideas on how we accomplished this because it is in learning what works that we can make more improvements faster!

Gilchrist Hospice Care and Gilchrist Greater Living continue their spectacular work in leading the region in compassionate, evidence-based care to seniors and those at the end of life. I applaud all the hard work that Gilchrist Hospice has done over the years to help so many individuals and families through the end of life. Gilchrist not only provides world class medical care to patients in their final days, but they also provide emotional and spiritual support.  In the past 20 years, Gilchrist Hospice Care has cared for over 40,000 patients and approximately 100,000 loved ones.

Please come and show your support for Gilchrist’s work by attending the Holly Ball this Friday, Dec. 12 at the Baltimore Marriott Waterfront.  This year’s black-tie event, which starts at 7:00 p.m., will benefit the Gilchrist Towson inpatient center. For more information on the Holly Ball, please go to . I hope to see you there!

Wishing all those who celebrate the Festival of Lights next week a very Happy Hanukkah!


  1. One thing that I believe helped with hand hygiene was placing the alcohol foam dispensers right next to elevators. It is a subtle yet important reminder to employees to keep hands clean as buttons on elevators and heavy traffic areas do in fact harbor bacteria. Seeing these stations all over the hospital and having easy access to them have functioned as reminders about hand hygiene to those traversing into other areas of the hospital.

  2. My family member was recently admitted and each nurse that entered his room, while I was there, cleaned their hands with the hand sanitizer that was affixed to the wall. It was greatly appreciated. I'm glad that there is a focus on this, so we can improve the care for our families and all patients.

    1. I agree. Our vision is that every patient, every time gets the care that we want for our own loved ones. I am glad that we hit this mark with your loved one. Thanks, Anonymous.


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