460. Teaching an Old Dog New Tricks—Environmental Cleaning Services Not So Set in Their Ways That They Can’t Be Taught Better Hand Hygiene Practices

BACKGROUND: Hand hygiene (HH) is the single most important practice in the prevention of healthcare-associated infections (HAIs). However, HH is commonly suboptimal, with compliance often only 30–60%. In 2010, the Joint Commission Center for Transforming Healthcare launched the Targeted Solutions Tool (TST) for Hand Hygiene to aid institutions to increase HH compliance. After successfully deploying the TST at our medical center in 2015, we noted a remarkable improvement in overall HH. Unfortunately, improvements in HH across services were not uniform. Some services, like the environmental services (EVS), remained set in their old ways and continued to perform suboptimal HH. METHODS: We continued to engage staff using the TST model and just-in-time coaching (JITC) to encourage best HH practices. In addition, we often met with small groups for HH huddles, and reinforced the importance of EVS staff and their HH in helping to protect themselves and our patients, and reduce HAIs. Increasing EVS leadership commitment was key to further engage EVS staff and encourage better HH amongst EVS staff. Review of HH metrics was hard wired into the daily functions of the EVS department. RESULTS: Figure 1 shows EVS HH compliance from January 2014 through October 2017. This highlights the substantial progressive, albeit slow, improvement in EVS HH practices from a baseline of 40% to 60% to 80% over the course of nearly 4 years. CONCLUSION: EVS HH rates remained suboptimal for prolonged periods. Initially the lack of leadership commitment and high staff turnover made training and engagement difficult. Continued interventions and use of just-in-time coaching proved to be effective to help improve compliance and better understand barriers to best practices. Connecting with EVS staff in small group huddles and the engagement of EVS leadership was key to success. [Image: see text] DISCLOSURES: J. P. Parada, Merck: Speaker’s Bureau, Speaker honorarium.