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Hand Hygiene Project: Best Practices from Hospitals Participating in the Joint Commission Center for Transforming Healthcare Project

In an earlier article on how JCI is improving healthcare worldwide, I mentioned the work of The Joint Commission Center for Transforming Healthcare.

For The Center’s first Robust Process Improvement (RPI) project, hand hygiene was chosen by eight leading hospitals. These hospitals used The Center’s Targeted Solutions Tool (TST), a six-step process to “measure performance, identify barriers to excellent performance, and customize solutions”.

From April 2008 through August 2010, the hospitals defined and measured hand hygiene, analyzed data, and improved processes and workflow using Lean Six Sigma. Fifteen major root causes of failure to clean hands were identified, and targeted solutions for each root cause or contributing factor were developed.


  • As of August 2010, all eight participating hospitals reported hand hygiene compliance rates at about 82 percent, and they are still monitoring the process to determine sustainability of their results.
  • Many of the hospitals have reported a decline in HAIs as their hand hygiene compliance rate has increased.
  • Solutions developed by the hospitals are part of the Targeted Solutions Tool (TST), a webbased tool provided free to Joint Commission‐accredited organizations. The TST allows organizations to customize solutions to address their specific barriers to excellent performance.

The American Hospital Association, a supporter of the Center for Transforming Healthcare, prepared a report on the findings:

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