5 Tips for Effective Digital Hand Hygiene Auditing Programs

Qualaris interviewed Tracy Stieglitz, RN, BSN, CIC, Infection Prevention Manager at Washington Health System (WHS) about their hand hygiene (HH) program. By automating HH auditing with Qualaris, WHS has captured +15,000 audits annually for the last 3 years.

Tracy and WHS have done some great work when it comes to HH and infection prevention:

  • they saved staff time by eliminating a cumbersome paper auditing process
  • they developed a strong culture around HH
  • they ramped up annual observations to +15,000/yr
  • they improved HH compliance from 62% to 96% over the last 5 years
  • they have reduced HAIs by 30% over the last 5 years

The Qualaris team is very proud of their accomplishments! And, we’re honored to support their work to keep patients safe.

Here are Tracy’s top 5 tips for developing an effective digital HH auditing program. We and Tracy hope you can use them to strengthen your organization’s HH program and get similar results.

Tip 1 - Develop a reliable digital data collection process with clear assignments & progress tracking

By automating HH auditing with Qualaris, WHS has captured +15,000 audits annually for the last 3 years.

Previously, when WHS used a manual, paper-based system, they struggled to consistently gather observations and report on HH. Papers got lost or “put in the mail”. WHS only had about 3,000 paper observations per year, and it was difficult to understand compliance levels. It was tedious to manually calculate the results. It was a challenge to act on issues or share learnings.

Make sure eliminating paper works for everyone by enabling multiple device options for digital data collection. “Using Qualaris is a big time saver. You don’t have to have piles of paper on your desk.” Tracy shared that WHS uses a variety of data collection devices to collect their audits including computers, smartphones, and tablets. While Tracy prefers using a computer, giving staff computer and mobile options on how they collect their data can help fit data collection into different staff workflows and preferences. “Staff can go right to the audit on any device with internet access, it really is as simple as the paper and pen for auditing, but much faster for reporting.”

A more reliable collection process is possible with the help of clear collection assignments and progress tracking with the help of Qualaris. At WHS they use secret shoppers. They started with a goal of 30 audits per department each month, and the manager can do more if they want. Tracy shared that it is important to have a list of who is responsible. She recommends using Qualaris’ dashboards to ensure collection is happening and staying on track. “If we want 20 audits in a month from a unit, I can look into the system to actually see how many they have done, and can drill down further to see exactly who has done the audits. It is very helpful to have access to the data this way.” If necessary, Tracy follows up to provide reminders. Tracy shared that this approach has also played an important role in reliable audit collection and ensuring they meet audit collection requirements set by organizations like LeapFrog.

If you have the opportunity to do so, get volunteers involved in HH audits. At WHS, they run a great patient advocate volunteer program. Tracy worked with this program to get the volunteers involved in HH auditing. “They love it. It is easy for them to do. They walk around the unit and monitor. They ask questions and give out treats if you get the hygiene question correct.”

Tip 2 - Raise executive support & performance visibility

Developing a strong culture around HH helped WHS foster friendly competition and even continue strong HH data collection and improvement through the challenges of the COVID-19 pandemic.

Support from leadership is key. “These days, it is not hard to find data to prove why HH is important because you can show correlations between HH and infection rates, but sometimes that’s not enough. The Administration at WHS makes HH a goal.” Relevant articles and information appear on the President’s page [on their intranet]. Results also go to the Board of Directors. One reflection of this strong support is a pledge that all staff take to complete best practices in HH.

Use reports to foster friendly competition and peer pressure. Friendly competition is a powerful dynamic, and performance visibility can help encourage it. “We post the graphs from Qualaris to show who is doing what, for example Nursing vs Respiratory. There is peer pressure and competition to say we need to really focus on HH.”

Drill down on areas for improvement to get more details and then share what you uncover. Tracy uses Qualaris to dig into the results and give more granular feedback to managers. “It is easy to drill down, to see who are the people and shifts which are not doing well and then say hey to the manager that your team is having a hard time.”

Tip 3 - Regularly engage and educate all departments

At WHS, every department participates in the program and has someone assigned to do HH.

Share regular updates on what’s being done. Regular communication about your HH program helps keep the topic top-of-mind. Tracy used a HH talking sheet that she emailed every month when launching the program to say where they were and how they were doing.

Use a huddle board or unit board to reinforce and educate. WHS highlights infections which get posted on huddle boards. They correlate HH compliance and the infections they had. They also show micro-pictures of the things they touch thinking they are clean to show the importance of maintaining hand hygiene.

Make sure you educate auditors for consistency. “Education is a key piece so that your observer knows how to observe and what to do. You can’t just have anyone do it. it is important that they are comfortable.”

Tip 4 - Review results with teams to find opportunities for improvement

At WHS, they’ve improved HH compliance from 62% to 96% over the last 5 years while also reducing HAIs by 30%.

Engage teams with the data to uncover opportunities for improvement. Collected data doesn’t do any good if it isn’t used to guide action. With less time spent tending to paper, IPs can spend more time helping staff understand their compliance data and how to make improvements. “Use Qualaris to show the data and then work with people to understand why there may be an issue with compliance for their unit.”  For example, WHS had a compliance issue with Nutritional Services so Infection Prevention partnered with them to identify issues and solutions. After analyzing the process and talking it over with the team, they developed clearer processes for HH while moving carts between rooms. They also installed hand sanitizers on carts to help make compliance more convenient.

Identify the right Qualaris reports to bring to each meeting. Qualaris supports a variety of chart formats that can be broken out by attribute like unit, shift, occupation, and more. Tracy uses reports generated from Qualaris for all Infection Control meetings, to show how teams are doing and where there are areas for improvement. “You can expect time savings because the data is in the system already. You don't have to calculate or add anything up like you do with paper. The data is easily put into reports which you can export in PDF.”  

Tip 5 - Use the Qualaris team as a resource for customization and new projects

Over time, Tracy has worked with the Qualaris team to support a variety of projects and HH-related needs.

Don’t be shy and make sure to connect with the Qualaris team. The Qualaris team loves providing hands-on help to our customers, and Tracy takes advantage of it. “I have worked with a lot of software companies. The Qualaris team doesn’t leave you to fend for yourself like some others do. They are very accessible and provide a high level of support. When I use the chat feature for help, within an hour or so they help me out. They walk through things with me, and they always get back to me.” Whether you need help customizing audits, thinking through the right tools for a new project, getting the right reports, or even providing educational webinars to staff, Qualaris is available and happy to assist.

Thank you, Tracy, and congrats on a great HH program!

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