Becker's Clinical Quality & Infection Control

33 Executive Briefing Electronic monitoring program helps hospitals achieve and sustain high levels of hand hygiene While hand hygiene compliance slipped during the pandemic at some hospitals, others were able to maintain a high level of compliance throughout. Ms. Homan described a data review of four of Ecolab's customers that had implemented Ecolab's Hand Hygiene Compliance Monitoring System, part of the Ecolab Hand Hygiene Program, prior to the pandemic. These four hospitals all achieved compliance in excess of 80 percent prior to the pandemic — and sustained that level of compliance during the pandemic. The reason for these results, in Ms. Homan's view, is that Ecolab's electronic monitoring system continuously monitors hand hygiene compliance in the patient zone for every healthcare worker. The system captures robust, actionable data by individual, shift, discipline, unit and patient across the hospital automatically. The program can help hospitals improve in areas like infection rates that significantly impact a hospital's total Leapfrog Hospital Safety Grade, according to Ms. Homan. The data captured by the system produces reports and analytics that allow hospital leaders to assess performance at all levels, providing visibility to where improvements are needed. Importantly, "What drives sustained behavioral change is that Ecolab's electronic monitoring system provides immediate feedback to the healthcare worker," Ms. Homan said. It does this through lights on the employee's badge — which can be green, yellow or red — and through a sound if an employee misses a hand hygiene opportunity. "It's a real-time reminder system, which is the best way we've seen to raise compliance, sustain compliance and change behavior," Ms. Homan noted. The process is built into the existing workflow, so if a healthcare worker is performing hand hygiene at the appropriate times, no change in behavior is needed. This ensures results that are sustainable whether healthcare workers are in triage mode during the pandemic, or not. Alleghany Health Network has experienced multiple benefits from the Ecolab Hand Hygiene Program Dr. Cotton summarized AHN's perspective: "The pandemic served to shine a spotlight on how we could (and should) be leveraging innovation and technology to support patient safety and free clinicians to spend their time caring for patients." At AHN, Ecolab's Hand Hygiene Compliance Monitoring System fits well with the health system's patient-focused approach. "Implementing this system across AHN has supported a culture of patient safety with both leadership and frontline staff," Dr. Cotton said. "The robust reporting capabilities is something that stood out," added Ms. Ferrelli. "Being able to report down to the individual employee helps bring ownership where it is needed most, at the bedside." Ms. Ferrelli also cited the program's actionable real-time data, which was lacking in previous solutions used at AHN. In addition, AHN has been able to reduce the number of observation audits required to demonstrate the health system's safety practices for Leapfrog. Ms. Binder mentioned that hospitals have a variety of ways of meeting Leapfrog's hand hygiene standard, of which electronic monitoring is one component. Taking a multi-modal approach goes beyond electronic monitoring Several years ago, Ms. Homan said, the World Health Organization came out with hand hygiene recommendations and included a multi-modal approach. The idea was that improving hand hygiene requires efforts along multiple dimensions, including education, training, feedback and signage. As part of a multi-modal approach, Ecolab has expanded its Hand Hygiene Program to include a new hand hygiene continuing education course, to keep nurses and other healthcare professionals up to date on hand hygiene. As part of its program, Ecolab has also created a Hand Hygiene Observation Tool, which is an app for smart devices to monitor hand hygiene compliance and quality. This observation tool provides an opportunity to verify whether individuals are washing their hands correctly and provides an opportunity for guidance and coaching. "It's about technique," Ms. Homan said. "It's about practice and it can augment an electronic compliance monitoring tool already in use." Conclusion Hand hygiene is a critical activity in healthcare; it always has been and always will be. Proper hand hygiene decreases infections and improves outcomes. The pandemic raised people's awareness of the importance of hand hygiene, which provides an opportunity to build momentum for better infection control in the hospital. Momentum can be built through an electronic compliance monitoring system, like Ecolab's, that provides accurate, actionable data and a variety of detailed reports. Ecolab's system provides these benefits without disrupting a health system's workflow. In addition to an electronic monitoring system, a holistic, multi-modal approach helps engrain handwashing in the organization's culture, creating and sustaining a culture of patient safety and compliance, and helping organizations achieve excellent Safety Grades. n Ecolab Healthcare is driven to help health systems and hospitals realize clinical, operational and financial value through repeatable and measurable workflows. Our standardized processes and digital dashboards provide actionable insights and opportunities for corrective actions that help reduce the costs and inefficiencies of infections, while improving margins and keeping patients and staff safe.

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