Improvement Stories

Hand Hygiene: Cleaner Hands, Safer Patients


Why is hand hygiene important to safe patient care?

Proper hand hygiene has long been a top patient safety priority at the MGH, with study after study demonstrating that healthcare-associated infections – which can lead to longer hospital stays, complications, and even death – may be spread from one patient to another via the hands of health care workers. According to the CDC, healthcare-associated infections account for an estimated 1.7 million infections and 99,000 associated deaths each year in the United States alone. The use of alcohol-based hand rubs before and after contact with every patient greatly reduces the spread of these infections.

What is the MGH doing to improve hand hygiene compliance?

The MGH has taken a multifaceted approach to improving the hand hygiene practices of its health care workers. A group called the STOP (Stop the Transmission of Pathogens) Task Force, with representatives from all major care groups, was created to address the issue. A comprehensive communication and educational campaign promoting proper hand hygiene procedures was launched across the institution in 2002, with designated hand hygiene “champions” to encourage compliance and educate peers on proper technique. Alcohol-based hand rub dispensers also were placed in additional places across the hospital, making it easy for staff to practice proper hand hygiene. In 2007, a modest hospital-wide bonus was awarded when MGH first achieved targets set by the Joint Commission.

Where are we now?

Since the inception of this new approach, hand hygiene compliance rates at MGH have increased from 8% “before contact” and 47% “after contact” with the patient or patient’s environment, to now consistently meet the 90% compliance expectations set by the Joint Commission. Some inpatient units have achieved the hospital’s ultimate goal of 100%. As hand hygiene practices and compliance have improved, MGH has observed a significant and sustained decrease in its rates for healthcare-associated cases of methicillin-resistant Staphylococcus aureus (MRSA). Incidence has decreased by half, despite a two-fold increase in the number of patients who arrive to MGH with MRSA infections. Steady progress has been made over the years, and the hand hygiene program has become one of the MGH’s most successful initiatives in improving patient safety. In fact, the program garnered external recognition as a recipient of the Betsy Lehman Patient Safety Recognition Award, which was presented by the Massachusetts Betsy Lehman Center for Patient Safety and Medical Error Reduction. Our challenge now is to sustain those gains and push on to achieve even higher levels of compliance.


« Previous Page