All hands on deck: improving medical staff compliance with hand hygiene

Katherine Pollaers 1, Helen Cadwallader 1, Kerry Birnie 1

Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA, Australia


The results from Hand Hygiene Australia demonstrate medical staff compliance with hand hygiene (HH) is below that of other disciplines. In a tertiary hospital in Western Australia a junior doctor completed a 10 week Clinical Service Redesign project, focusing on improving HH compliance amongst medical staff at the institution.

A Clinical Service Redesign framework was used that included the principles and methodologies of Lean Six Sigma. Consultation occurred with doctors of all levels. A root cause analysis was undertaken and contributing factors to poor HH compliance were identified. Following this, “solutions” sessions were held to address the issues identified.

The root causes identified included themes such as a lack of Consultant leadership, poor personal HH (including that HH is not a habit for doctors) and ward round logistics often being prohibitive to HH.

The solutions included:
• Designing a suitable trolley for use on the ward round.
• Auditing HH on the ward rounds by a credentialed hand hygiene auditor with results published in a ‘leader board’ fashion.
• Engaging senior doctors in each department to ‘champion’ HH and be responsible for reacting to leader board results.
• Developing visual ‘Remind Me!’ prompts to be worn intermittently by medical staff to encourage healthcare workers from all levels to perform HH.

The solutions continue to be implemented and the lessons learnt will be presented. Regular re-auditing continues to monitor the success of the interventions. Engagement of the medical staff in HH has been invaluable in the project.

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