Report: US hospitals see sevenfold improvement in hand hygiene compliance since 2020

Editor's Note

According to this report published by The Leapfrog Group this month, hospitals in the US have significantly improved hand hygiene compliance, with 74% meeting the Leapfrog Hand Hygiene Standard in 2023, up from 11% in 2020. Among other factors, the report attributes this improvement to increased use of electronic compliance monitoring (ECM) such as door minder technology or electronic badges to track hygiene practices in real-time, which doubled from 4.7% in 2020 to 10% in 2023.

Leapfrog’s standard emphasizes five critical domains: monitoring, feedback, training, infrastructure, and culture. One example the report notes is the vast majority of hospitals employing hand hygiene coaches or compliance observers, a figure which has also increased significantly—from 58.7% in 2020 to 92.4% in 2023. Additionally, hospital leadership accountability has played a crucial role, with 86.3% of hospitals tying hand hygiene performance to leadership reviews or compensation in 2023 (up from 48.6% in 2020).

The report does highlight gaps, noting that although hospitals are on the right path, at least 559 of them still do not meet the Leapfrog standard, potentially putting patients at risk. In terms of infrastructure, 96.3% of hospitals have processes to help ensure “hand hygiene supplies are readily available,” a significant improvement since 2020, per the report. Moreover, physical demonstrations of proper hand hygiene techniques are becoming more common, though 307 hospitals still don’t require this for initial training.

Leapfrog’s analysis emphasizes that improving hand hygiene compliance is essential for patient safety, and that continued efforts are necessary to reach 100% compliance. The data from the report is drawn from nearly 2,100 hospitals, representing 74% of US hospital beds.