Hand hygiene compliance reduces rates of health care-associated infections in hospitals, but has proven difficult to sustain. The most recent issue of The Joint Commission Journal on Quality and Patient Safety takes a closer look at the issue.
In the first article, “Improving hand hygiene at eight hospitals in the United States by targeting specific causes of noncompliance,” Mark R. Chassin, MD, president and chief executive officer of The Joint Commission, and co-authors, provide a detailed account of The Joint Commission Center for Transforming Healthcare’s first patient safety project on hand hygiene. The Center convened teams of experts in performance improvement and infectious diseases from eight hospitals for the project, which was conducted from December 2008 to September 2010. Lean, Six Sigma and change management methods were used to measure the magnitude of hand hygiene noncompliance, assess specific causes of hand hygiene failures, develop and test interventions targeted to the specific causes, and sustain improved levels of performance.
In the second article, “Beyond the collaborative: Spreading effective improvement in hand hygiene compliance,” Dr. Chassin and colleagues chart the development of the Center’s Targeted Solutions Tool® (TST®) for hand hygiene. The tool helps organizations discover the most important, specific causes of hand hygiene noncompliance in their facilities and target interventions at those causes.
In an accompanying editorial, “Toward more reliable processes in health care,” Peter Pronovost, MD, PhD, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine, supports the implementation of using Lean, Six Sigma and change management methods in health care. Dr. Pronovost emphasizes the importance of managers and leaders championing quality improvement processes as a way to direct their health care organizations. The editorial concludes, “In the struggle to find the balance between art and science, patients would be better served if more emphasis was placed on management science.”
The Joint Commission Journal on Quality and Patient Safety, available by subscription, is a monthly, peer-reviewed publication that promotes the quality and safety of health care.
