Major articleChallenges in implementing electronic hand hygiene monitoring systems

- Electronic hand hygiene monitoring systems (EHMS) are challenging to implement.
- Implementing an EHMS may disrupt physical infrastructure and clinician workflow.
- An EHMS should fit the healthcare organization's culture and budget.
- Front line workers have concerns about EHMS accuracy and how the data will be used.
- Targeted direct observations of HH compliance may be needed to supplement an EHMS.

Electronic hand hygiene (HH) monitoring systems offer the exciting prospect of a more precise, less biased measure of HH performance than direct observation. However, electronic systems are challenging to implement. Selecting a system that minimizes disruption to the physical infrastructure and to clinician workflow, and that fits with the organization's culture and budget, is challenging. Getting front-line workers' buy-in and addressing concerns about the accuracy of the system and how the data will be used are also difficult challenges. Finally, ensuring information from the system reaches front-line workers and is used by them to improve HH practice is a complex challenge. We describe these challenges in detail and suggests ways to overcome them.