Hand hygiene is important for patient safety; increasing hand hygiene compliance may reduce thefrequency of healthcare-associated infections. This paper describes a distributed system that usesinstrumented product dispensers and doorway monitors to systematically measure hand hygienecompliance as an alternative to compliance measurements by human observers, which is the currentstandard. The paper describes two experiments. The first experiment monitored 4,266 doorway crossingsand 858 hand hygiene dispenser events for 4 patient rooms over 80 consecutive hours. The secondexperiment was part of a larger effort that included a direct comparison of a human observer with theautomatically recorded observations. The results of the two experiments suggest that large quantities ofdata could be readily acquired, but the data was sensitive to several limitations not suffered by humanobservers including: distinguishing between single versus closely spaced multiple threshold crossings anddistinguishing staff from patients and visitors. However, a direct comparison of human versus machinereadings suggested that the system might overcome observational challenges faced by the human observers,providing more consistent and reliable measurements.
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