PowerPoint Presentation

Hand Hygiene Measurement TechnologyJanuary 2015Presenter:Jane Kirk MSN RN CIC Clinical Director HealthcareGOJO Industries, Inc.

LEARNING OBJECTIVESAt the end of this presentation you will be able to:

Describe 3 barriers to hand hygiene complianceName 3 technologies to consider for measuring HHDiscuss and identify the differences between AMS and RTLS

4Hand Hygiene & Healthcare Associated Infections

Why is This Important?51.7M HAIs are reported each year

99,000 deaths each year, attributable to HAIs

1 out of every 20 hospitalized patients will contract an HAI

Length of Stay (LOS) increases up to 18 days

HAIs cost the U.S. health care system billions of dollars each year

CDC cites proper hand hygiene as #1 intervention in fighting HAIs

Compliance rates in the US average less than 50%

Global research indicates that improvements in hand hygiene activities could potentially reduce HAI rates by up to 50%

Why is hand hygiene compliance so low?Too busyhigh workloadshands fullmultiple distractionsHCWs forgetalready thinking about next taskInconvenient placement of sinks and dispensersSkin irritation and dryness due to handwashingNot a habitsafety culture doesnt stress importance of hand hygiene at all levels of organizationInadequate knowledge of hand hygiene guidelines and protocols

*2009 Joint Commission Center for Transforming HealthcareAverage Compliance is less than 50%, nationally66

In almost all cases, hospitals did not receive full reimbursement; on average, hospitals statewide were paid approximately 27% of the established charges.

The hospital must absorb the additional costs associated with HAIs, while the HAIs simultaneously prevent new admissions w/ reimbursable conditions.Economics of HAIs

Economics of HAIsBusiness Case / ROI Focus:Excess cost of HAIs Hospital dependentExcessive length of stay (LOS) lost opportunity costDefine multi-modal strategy and needed resources

Hand Hygiene Improvement = Higher Standard of CareHow is hand hygiene monitored today?CONFIDENTIALDirect observationConsumption modelingPatient Surveys

So lets walk through the current methods of HH monitoring to understand what they are, and the results they provide to infection control professionals for gauging HH compliance.

10Compliance Management ApproachesArea/Group MonitoringPerson Specific MonitoringDirect (manual) ObservationVideo SurveillanceCostImpactObservation AppsThis slide shows the various buckets that all available technology falls into.At the lowest cost / lowest impact is direct observationThe GOJO SmartLink system resides in the Activity bucket and our RTLS partners reside in the Person specific bucket.Additionally, no matter the technology, GOJO is able to make our TFX and LTX dispensers work with each

11Three Primary Technologies to Consider Area / Group MonitoringIndividual / Role MonitoringDirect Observations Apps

Option #1 Activity/Group MonitoringNot Big BrotherCommunity metric / no badgesTeam based performanceGroup-level reporting structureLittle IT infrastructure requiredEntry/Exit activityDispenser activityCompliance by locationBuilding, floor, unit, roomAutomated Reporting 24/7

The first technology category to review is Activity-Based Monitoring solutions. With this type of system, (2) metrics are monitored:(1) Area entry / exit and (2) Dispensing activity tied to a specific area

A key point to consider with this technology, is that it is not intended to eliminate Direct Observation, rather, it is intended to compliment it. This type of system does not indicate who is entering or exiting an area or who is dispensing, rather it simply logs and displays that a person foamed-in and then entered a room (as a example). This type of system, typically does not require IT infrastructure to be operated and typically is set-up as a stand-alone system, again, separate from the hospitals IT infrastructure.

Some benefits are of this technology is:Ability to monitor trends and patterns in hand hygiene complianceIt provides near real-time metricsIt can provide data by location or area and is monitoring 24/7 when implementing this type of technology, expect your data pool for monitored event to exponentially increase.(and last)It does not have person-specific implications, such as the big brother aspect.

13Fewer purchases, reduced rentals, loss preventionProductivity, quality performance, safetyPMs, locating,change in statusSpoilage - pharmaceuticals, blood, organs ER wait times, OR / bed schedulingImprove Patient Care Reduce Costs Increase Safety ROIAsset Management

Equipment Maintenance

ConditionMonitoring

Patient & Staff Safety

Hand Hygiene

Reduce HAIs, Improve outcomes Patient Flow

Option #2 RTLS / Individual MonitoringThere are 5 Common Use Cases, or Applications within RTLS:

And a hospital can implement one or all of the applications, depending on their needs. The goals for this type of system are to improve patient care, reduce costs, and increase the safety of the patient and HCW.

Asset Tracking provides the ability to locate, track, and better manage critical mobile assets for maximum return on investment. It also increases staff efficiency, improves workflow and significantly reduces search and wait times for ordered equipment. Beds, infusion pumps, mobile monitoring devices, and wheelchairs.

Equipment Maintenance Know when devices are due for maintenance, or are showing signs of failure, ensuring you have the right assets, working well, when they are needed.

Condition Monitoring used for critical hospital assets such as blood, tissue, organs, and pharmaceuticalsany variation in temp or humidity is reported immediately to administrative staff

Patient & Staff Safety helping managing patients that are at risk for wandering, alerting staff if they enter areas that are not safe/allowed. Staff duress alerting to inform HCWs when a colleague has been put in a dangerous situation or needs assistance with a patient that could cause them harm.

Patient Flow helps manage patient throughput and productivity by reporting on the movements of a patient from admission to discharge, so hospital staff can create efficiencies in patient flow (such as in emergency departments).

Hand Hygiene the newest Use Case being deployed by RTLS companies is Hand Hygiene. This use case monitors HCW HH practices, and reports their individual, role, or team compliance rates. The goal of the HH use case is to REDUCE HAIs and IMPROVE OUTCOMES.

14RTLS SoftwareBadges

Sensory Network

Dispensers

Option #2 RTLS / Individual Monitoring

How does this technology work relative to hand hygiene compliance?

RTLS technology and platforms actually are very similar to an Activity-Based system with two primary differences:

1. Badges (or a similar device such as a wristband or portable device) are used with this type of system in order to monitor an individual(and second)2. The IT infrastructure needed is much greater in most cases.

To briefly explain how this type of system operates, these are the basic steps:The system will record when a person (wearing a device) enters or exits a roomDispensers utilizing some type of communication device will record a person-specific wash-in and wash-out event via the RTLS device being worn on the individual.The RTLS device will then record & communicate the hand hygiene event data to the designated RTLS system.Hand hygiene compliance activity is then presented via a dashboard15

ECM Dashboard & ReportingCustomized reportingProvides data by:Location (floor, unit, room)Formulation (soap vs. sanitizer)Date rangeShiftDeviceRolePersonData available 24/7

Direct Observation System / APP

App for iPad / iPhone & AndroidAuto-feed into SoftwareIncreases standardization of dataSignificant increased efficienciesStatistically relevant dataPen / PaperExcel / PowerPointTime ConsumingProne to Errors

17Video monitoring Motion sensors that detect patient room entry and exitWearable devices that dispense sanitizer & track HCWsWrist worn devices that track HH events and techniquesPatient tracking devicesVirtual wall technologySMART Dispensers

Additional Technology

Measurement Alone is not Enough

A Few Methods to Improve Hand Hygiene Compliance:

Staff & Patient EducationObservation & FeedbackConvenient Dispenser PlacementRemindersSanctions & RewardsLeadership Engagement / PriorityAvoid Understaffing / Excessive Workload

Hand Hygiene = #1 intervention in fighting HAIsYou cant manage what you cant measure

Q & A