Sustained improvement in hand hygiene adherence: utilizing shared accountability and financial incentives
| Autor: | William Schaffner, Jennifer M. Slayton, Nancye Feistritzer, Gerald B. Hickson, Greg Wilson, Thomas R. Talbot, Titus L. Daniels, Claudette Fergus, John Henry Domenico, James G. Johnson |
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| Rok vydání: | 2013 |
| Předmět: |
Microbiology (medical)
Employee Incentive Plans Epidemiology media_common.quotation_subject Health Personnel Observation Nursing Hygiene Health care Outpatient clinic Medicine Humans Organizational Objectives Hand Hygiene Goal setting Reimbursement media_common Academic Medical Centers Social Responsibility business.industry Organizational Culture Leadership Infectious Diseases Accountability Practice Guidelines as Topic Observational study Guideline Adherence business Social responsibility |
| Zdroj: | Infection control and hospital epidemiology. 34(11) |
| ISSN: | 1559-6834 0195-9417 |
| Popis: | Objective.To evaluate the impact of an institutional hand hygiene accountability program on healthcare personnel hand hygiene adherence.Design.Time-series design with correlation analysis.Setting.Tertiary care academic medical center, including outpatient clinics and procedural areas.Participants.Medical center healthcare personnel.Methods.A comprehensive hand hygiene initiative was implemented in 2 major phases starting in July 2009. Key facets of the initiative included extensive project planning, leadership buy-in and goal setting, financial incentives linked to performance, and use of a system-wide shared accountability model. Adherence was measured by designated hand hygiene observers. Adherence rates were compared between baseline and implementation phases, and monthly hand hygiene adherence rates were correlated with monthly rates of device-associated infection.Results.A total of 109,988 observations were completed during the study period, with a sustained increase in hand hygiene adherence throughout each implementation phase (PP< .0001), such that adherence greater than 85% has been achieved since January 2011. Medical center departments were able to reclaim some rebate dollars allocated through a self-insurance trust, but during the study period, departments did not achieve full reimbursement. Hand hygiene adherence rates were inversely correlated with device-associated standardized infection ratios (R2= 0.70).Conclusions.Implementation of this multifaceted, observational hand hygiene program was associated with sustained improvement in hand hygiene adherence. The principles of this program could be applied to other medical centers pursuing improved hand hygiene adherence among healthcare personnel. |
| Databáze: | OpenAIRE |
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