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December 2008
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Novant Health Improves Hand Hygiene Compliance, Reduces MRSA Infections
James Lederer, MD
Novant Health was recently named a national winner of the Joint Commission’s 2008 Ernest Amory Codman Award. The prestigious Codman Award is presented to organizations that demonstrate exemplary performance to achieve healthcare quality improvement.
The health system was honored for its work in reducing the spread of methicillin-resistant Staphylococcus aureus (MRSA) infections through its successful efforts to improve hand hygiene compliance.
“Washing hands seems like such a simple task,” says Paul Wiles, CEO and president of Novant Health, “but it took a relentless and creative solution to improve our health system’s hand hygiene compliance. We were honest with staff, telling them that we could save patient lives if we were all successful. And now we know that our improvement spared patients from the complications of MRSA.”
| Novant’s no-holds-barred approach to hand hygiene worked. Compliance dramatically increased from 49% to 99% in just 2.5 years, and, more important, the behavior change led to a 53% reduction in hospital MRSA infection rates across the healthcare system. That reduction means that 249 patients from 2005 through 2008 did not suffer the medical complications of MRSA. |
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The hand hygiene campaign began in 2005 as a 3-year corporate initiative. Our goal was to achieve 90% hand hygiene compliance based on Centers for Disease Control and Prevention guidelines for healthcare facilities. Development of the overall program was coordinated through the Clinical Improvement Department following the Plan-Do-Study-Act/rapid-cycle improvement model. Development, monitoring, and oversight of the goal were managed by a multidisciplinary team comprising clinical leaders from the medical, nursing, and infection prevention staff, as well as administrative, marketing, and communication leaders. Metrics were proposed, and a process was developed to measure hand hygiene compliance. Policies and procedures were updated; two additional RN-trained staff were hired to support the initiative by conducting the hand hygiene observations, providing immediate performance feedback and education to the staff, aggregating data, and reporting to the organization on our progress. The team developed an honest internal communication campaign that included screen savers, cling stickers, billboards, yard signs, and other tactics to educate and help change behavior.
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“It’s nice to be recognized with this national honor, but it’s even more rewarding to share what we learned about improving patient care with other hospitals and health systems,” said Wiles. After receiving inquiries from hospitals around the country, Novant decided to create a Web site where interested organizations can download free materials used in the hand hygiene project. To date, more than 300 hospitals, clinics, and healthcare systems have used some or all of Novant’s materials to improve hand hygiene in their own facilities. |
Named for the physician regarded in healthcare as the “father of outcomes measurement,” the Ernest Amory Codman Award showcases the effective use of performance measurement by healthcare organizations to improve the quality and safety of healthcare. Novant Health is the recipient of the award in the multiple-organization category. Novant also received this award in 2004 for its work in reducing adverse drug reactions among patients receiving anticoagulation medications, or blood thinners.
James Lederer is medical director of clinical improvement at Novant Health, Winston-Salem, NC.
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