Safer Patients Initiative in the UK Has Dramatically Improved Effective Hand Hygiene Standards

This story originally appeared in IHI's 2007 Annual Progress Report.


Proper hand hygiene is the single most effective method to reduce hospital-borne infections.

With the support of The Health Foundation in London, IHI is leading a nationwide quality and performance improvement program in the United Kingdom called Safer Patients Initiative. Improving hand hygiene in four pilot sites in the National Health Service is one of the program’s many efforts.
Pat O’Connor is head of risk management and patient safety for NHS Tayside in Scotland. “We used to visit the wards to audit hand hygiene compliance on an annual rotation,” she says. “Everyone knew who we were, so compliance was very high. But IHI taught us that you have to measure improvement over time, and the effort should be owned by the people on the ground. So the senior charge nurses attended national meetings and trained as cleanliness champions. Now they have teams on site that can measure and record hand hygiene frequently, quickly, and quietly.”
O’Connor says they also learned what to measure. “You have to measure opportunity. Are they washing before AND after patient contact, as the guidelines say? It’s harder than it seems, so some of the early scores were quite low.” But O’Connor reports that now, all ICUs in the four sites are at about 90 percent compliance.

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