Development of the initial Leapfrog Group’s hand hygiene standard

Abstract

Background

Health care-associated infections (HAIs) remain a major concern in US hospitals, contributing to significant patient mortality and medical costs. Studies indicate that up to 70% of HAIs are preventable, with proper hand hygiene the most effective method of preventing transmission. Despite this, adherence to hand hygiene in hospitals remains low.

Methods

This article describes the process of developing, testing, and refining a standard to improve hand hygiene adherence in US hospitals. Building on the published literature and guidance from a national expert panel, Leapfrog developed a standard with 5 key domains.

Results

In 2019, 1,698 hospitals pilot tested an initial set of survey questions intended to measure hospital performance against the hand hygiene standard. Responses were not scored, but reviewed to make refinements. The scoring of hospital responses to the survey questions and the public reporting of hospitals’ performance on meeting the hand hygiene standard began in 2020. From 2020 to 2023, the percentage of reporting hospitals that have met each domain of the hand hygiene standard and fully achieved Leapfrog's hand hygiene standard continued to grow.

Conclusions

Leapfrog's hand hygiene standard provides hospitals with a "how-to guide" for best practices to promote hand hygiene and prevent HAIs.