Improving Hand Hygiene at Eight Hospitals in the United States by Targeting Specific Causes of Noncompliance

Lean, Six Sigma, and change management tools were used to identify specific causes of hand hygiene noncompliance at individual hospitals and target specific interventions to remedy the most important causes. This approach allowed each hospital to customize its improvement efforts by focusing on the causes most prevalent at its own facility. Such a targeted approach may be more effective, efficient, and sustainable than “one-size-fits-all” strategies.