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Success Stories

  • Hospital-wide Improvement at Johns Hopkins.
    In November 2007, The Johns Hopkins Hospital started a new hand hygiene program aimed at improving our compliance rates with hand hygiene protocols. The program included leadership engagement, a communications campaign, educational videos, environment optimization and an online reporting tool. Since the program began we have more than tripled our hand hygiene compliance rates. Learn more about the story.
  • Unit-based Hand Hygiene Monitoring.
    Units within the Johns Hopkins Hospital have added a local flavor to the WIPES program. Campaign materials are constantly being refreshed. Learn more about this story.

Hospital-wide Improvement at Johns Hopkins

Leaders of the Johns Hopkins Hospital knew that while our health care workers had long heard that washing or sanitizing their hands was the most important thing that they could do to prevent hospital-acquired infections, they often missed opportunities to practice proper hygiene. And changing people’s habits wasn’t going to be as simple as writing a new policy or issuing do-as-I-say dictates.

The first step our Johns Hopkins team took in November 2007 was to work with staff to understand what we needed to do to reach our health care workers. We then created a communication/education campaign that reflects the idea that frequent, appropriate hand hygiene is the norm. The campaign materials show smiling members of the hospital team, from clerical staff members to our CEO, raising their left hand in a friendly gesture as if making a pledge. “You can count on me,” the text reads, “to take the 5 steps to help WIPE out hospital infections.” The poster  then spells out the WIPES steps.  This open-handed gesture became our nonverbal —and non-confrontational—cue to remind others to follow proper infection-control practices.

Our second step was to optimize the hospital environment to enable health care workers to practice good hand hygiene. This included ensuring that we had enough hand sanitizer dispensers outside each patient room and following up with educational outreach to underscore the need to use those dispensers. We also designed a “secret shoppers” hand hygiene measurement methodology that replaced controversial self-reported information with objective, reliable data on how often hand hygiene protocols were followed. Hand hygiene compliance rates roughly doubled in the three months following the campaign’s launch.

Seeking to build on the momentum, our team implemented several further interventions including improved leadership engagement, efforts to refresh our education campaign and launching an online reporting tool. Using this powerful web-based reporting tool, we made hand hygiene compliance data more available to our leadership. This change enabled institutional leaders to bring the compliance data to staff meetings and help create unit- and department-specific action plans to improve hand hygiene. To promote institutional transparency and provide front-line staff direct feedback on their units’ performance, we made the same database and web-reporting tool open to all Johns Hopkins employees. Feedback to leadership and front-line staff triggered a series of initiatives that boosted our campaign, including unit-based monitoring, unit-specific communication campaigns and the Hand Hygiene Super Star hospital-wide recognition program.

WIPES empowered our staff and supported behavior changes that uphold good infection-prevention and hand hygiene practices. Using the five complementary components of the program (leadership engagement, a communications campaign, education, environment optimization and feedback), The Johns Hopkins Hospital realized great results.

Contact us if you’d like help setting up a similar program at your hospital.

Unit-based Hand Hygiene Monitoring.

By early 2008, The Johns Hopkins Hospital’s infection-control leaders could credit a communication and education campaign with doubling the rate of compliance with hand hygiene protocols to roughly 40 percent. But hospital leaders knew that the rate needed to be higher. So in the summer of 2008, hospital leaders made a fresh attempt to focus the staff’s attention on the subject. The Hospital Epidemiology and Infection Control group formed a hand hygiene task force that included representatives from nearly all hospital units. These representatives shared their strategies and successes with one another. The task force also employed a healthy dose of competition by posting unit-specific compliance rates on a new Intranet site.

Departments were supplied with educational materials and online training to help improve their scores and develop unit-based monitoring, a program that complemented the “secret shoppers” collecting more formal hand hygiene compliance data. An online toolkit instructed the units on the steps they should take and offered a meticulous checklist of proper procedures along with examples of initiatives other units had tried.

The push to improve hand hygiene compliance energized units across the hospital and inspired them to come up with their own unique programs. At Hopkins Hospital’s Osler 8 surgical unit, for instance, nurse-manager Sondra Garlic would hand a “secret key” to a staff member, a signal for that person to surreptitiously monitor hand-washing practices on the unit and recognize the person who practices hand hygiene most consistently that day.  And on a pediatric oncology unit, signs outside each patient’s room featured a photo of the child and the words, “What have you touched before you touched me?”

By March 2009, the hand hygiene compliance rate had climbed by another 27 percentage points.

Contact us if you’d like help setting up a similar program at your hospital.

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WIPES Reduces Transmission

wipesImproved hand-hygiene at The Johns Hopkins Hospital has led to reduced transmission of MRSA and VRE. Read the story.

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