Start With An Approximation
Rutger's food safety risk authority, Dr. Don Schaffner, reacts to the approximation strategy in opening the door to a risk-based sustainable handwashing process:
Healthcare facilities make few important decisions without data, without standards, without goals. Yet for hand hygiene, there are virtually no standards and no meaningful reporting. Care givers are trained to wash but not to a standard. They are asked to wash often, but again, without even a range of handwashes expected for a shift. Nor are there standards for the high-touch surfaces that most likely are contaminating clean hands.
The "Selector" curve first captures the experience of the persons most knowledgable about the operation. They post their vote for likely current handwashing rates and a level for where they want to be. Then actual frequencies are then captured, prefereably using technologies listed in the Commit & Comply matrix. Safe levels attained? If yes, relax and celebrate! Shortfalls? Get the team together and consider conducting a separate hand hygiene audit.
Commit & Comply
Setting standards for quality and frequency goes a long way in changing behaviors and sustaining the improvements. Before starting this phase, refer back to Step One of the HandsOn System to seek agreement on the risk of potentially low compliance. Verbalize and document the agreed risk. Commitment to specific action paves the way to success. Measurements themselves become motivating as caregivers hit their targets. The HandsOn System guides their implementation and protects the process.