It’s been 150 years since. We need to talk about hand hygiene, but in a different way. Hand hygiene compliance has been a nagging problem but it shouldn’t be, because practicing hand hygiene illustrates your commitment to beneficence. As a patient, it feels great to receive care from a healthcare professional that demonstrates care. Hand hygiene is one way that visibly demonstrates that. It builds trust. That’s how I want to feel as a patient.

Hand hygiene is a 150 year old practice that is largely still remain buried. Things haven’t changed much. We still talk about compliance, monitoring, mystery audits and validation audits when we should be advancing to right practices, nudges, contextual feedback, coaching and safety culture design and execution. Care and treatment of patients have become more complicated as the healthcare environment becomes more complex. Emerging infections, new technologies, multiple treatment protocols and varied healthcare settings all contribute to a complex environment and increased risk of infection. We still aim for a high compliance rate but with little context and understanding over what it means and unable to unravel its complexity. Where did compliance happened and where it did not? When to intervene? What feedback to give? The best value from direct observation is when we can use clinical examples to explain hand hygiene to a staff, like ‘after taking the patient’s blood pressure’ for a Moment 4 and explaining simple activities like ‘after you move the patient’s belongings’ to a housekeeper for a Moment 5. This brings concepts down to practice and people can relate to it and take ownership of it when they truly understand the context of what they are doing. Compliance data alone cannot do this. Without granularity of data to understand what happened, compliance reports exist in a vacuum, unable to identify root causes and equally unable to drive compliance decisions at the point of care.

And yet today, more technology is developed to enforce 24/7 automated monitoring, as though healthcare professionals have lost their way to first do no harm. Hand hygiene feels like a chore that needed constant reminding. Posters, awareness and promotion campaigns are rinsed and repeated, causing fatigue. Is more of the same going to solve the problem?

Hand hygiene is simple. It has made hospitals safer. But let’s be honest. Hand hygiene is about being self accountable and therefore must first be accepted by each individual. We believe the gap between 0% and 100% compliance is surrendering and accepting that hand hygiene is a moral, personal and professional obligation. It is like crossing the streets. The mind doesn’t negotiates. It just navigates how to cross safely. It is what it is. No lasting change will happen if we still think it is negotiable, subservient to other more important tasks or safety protocols.

Join us in our mission in enrolling people to accept hand hygiene and switch to a winning strategy. Daily we work with leading hospitals using this approach and the tools we provide to win people over because fundamentally, compliance to hand hygiene is a choice and an outcome, not a goal.