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Case Study Abstract



Handhygiene describes a term that is used to refer to the process ofremoving microorganisms using a disinfecting agent such as soap oralcohol and water (Kahanet al., 2014).Health care organizations should emphasize the importance of handhygiene in its organizational culture. The process needs to becarried out by healthcare employees so as to prevent hospitalacquired infections among patients. In this report, a case of handhygiene involving London Health Science Center (LHSC) would bediscussed and recommendations provided.


of Facts

LHSCis a health facility that is based in London. It is one of theCanada’s largest teaching hospitals in the area of acute care. Theentity is dedicated to providing excellent care to patients,providing training services, as well as engagement in research(House,2012).The organization was part of a pilot project initiative, in 2007,which was referred to as “Just Clean Your Hands.” Although theconformance of hand-washing had been improving since the introductionof the initiative, hand hygiene compliance rates were notaccomplishing the set targets that had been estimated by the Ministryof Health in the Ontario Province (House,2012).In the hospital, compliance to the hand hygiene program wasconsidered low, which could be attributed to the organizationbehavior. However, the organization was not the only in the provincewhose rates of conformation were low, but there were other firms inthe region having low levels. Generally, in the industry, the handhygiene initiative emerged as a problem.

Symptomsin the Case

Therewere different aspects leading to the compliance problem to the handhygiene campaign in the organization. One of the elements was theworkload. The hospital staff members were usually busy or in a hurry,which made the cleaning process to be rushed, or even some steps wereskipped (House,2012).This made it difficult to have 100% compliance to the four moments ofcare. The fear that cleaning hands severally could cause irritationor dryness of hands also affected full compliance. Besides, somereligious faiths were against the utilization of alcohol-based rubs,which also influenced the rate of conformance. Another factor was theinconvenience location of alcohol rub dispensers and sinks (House,2012).Furthermore, the behavior adopted by medical practitioners as well asthe support staff was hard to change. In addition, staff members werehesitant to talk in case they came across other members notconforming to the procedure of hand-cleaning.


Fromthe case, it can be indicated that although organizations in theindustry were dedicated to providing excellent services to patients,hand hygiene was an issue. However, through the “Just Clean YourHands” campaign, organizations such as LHSC improved therequirement of hand hygiene, but the estimated targets of compliancewere not attained. Also, it is possible to improve the rates ofcompliance in case organizational behavior and other interventionsare put into consideration.


Theinformation was based on the assumption that the data that wasprovided by Noble was correct and that there was no bias during thecollection process.



Corporateculture is exceedingly important in determining the manner in whichemployees conduct themselves. Every entity needs to have a culture,which workers need to conform to in making the processes of anorganization a success. The problem that LHSC has, which iscontributing to the issue of low compliance rates to the hand hygienerequirement, is that it has no discipline mechanism for physicians aswell as other staff that can be followed for the failure of followinghand hygiene procedures (House,2012).The problem is partly contributed by the organization having many ofits staff members being unionized and its physicians beingcontractors rather than employees. This makes discipline to become anexceedingly difficult issue.

StrategicPositioning and the Problem

Thestrategic positioning of an organization is critical in establishingthe performance of an organization in the future. LHSC positionsitself to become a leader in the provision of health care services topatients through integrating quality care and patient safety.However, the low compliance of the organization in the hand hygienerequirement is negatively affecting the strategic positioning of theentity. This is because the low compliance rates would make thecompany rank lowly in the area of patient safety and quality of caresince it would be possible for patients to acquire hospitalassociated infections (Pittetet al., 2016).



Thereare four moments of care that can be used in gauging the complianceof the hand hygiene requirement. An analysis of whether there was animprovement in compliance between 2009 and 2010, the assessment wouldbe as follows







University Hospital



Victoria Hospital



University Hospital



Victoria Hospital




University Hospital



Victoria Hospital



University Hospital



Victoria Hospital


For2009, average compliance in moments 1 and 4 in the hospital was (52%+ 58% + 83% + 80%)/ 4


For2010, average compliance in moments 1 and 4 in the hospital was (65%+ 74% + 81% + 86%)/ 4


Fromthe analysis, it can be indicated that there was an increase in thelevel of compliance in the organization between the year 2009 and2010.

QualitativeAnalysis of Customers, Competition, and Issues Related to SupplyChain

Emanatingfrom its regional excellence, the organization has become a regionalreferral center providing a broad range of services to customers. Therates of client satisfaction for the services received from thehospital are high due to the growth of infrastructure and improvementof patient outcomes. Patient safety is a priority for LHSC, whichenhances the rates of customer satisfaction. The company competeswith other Health Sciences Centers, which are located in London. Suchcenters include the Massachusetts Life Sciences Center, Museum ofScience, and Crayola among others. Because of the company’sinfrastructure, it has been possible for the entity to competeeffectively in the London market. Improving service quality whilemitigating cost has been hard to achieve among the hospitals inOntario. However, Healthcare Materials Management Services (HMMS) hasbecome a joint venture of the LHSC and SJHC. Therefore, the supplychain of the company is well organized.


Strengthsand Weaknesses

LHSChas strength in the number of staff members (House,2012).In the provision of care services, there is a need to have a largenumber of caregivers since it ensures that patients are well-servedin a timely manner. Also, a high number of staff members issubstantial because it eliminates the issue of staff exhaustion,which helps in improving the working of the care providers andimproves patient outcomes (Tweedy, 2014). Being a health sciencecenter, the organization is in a position to provide trainingservices, which supports the operations of the company in terms ofoffering highly-skilled practitioners who can provide qualityservices to the masses. From the case scenario, the firm has aweakness in that it operates under a fixed budget, which may hindersome of the issues that may emerge (House,2012).

Opportunitiesand Threats

Theentity has an opportunity of enhancing its performance in the OntarioProvince emanating from the increasing compliance rate of the handhygiene requirement. The improvement realized by the company may makemore patients seek services from the organization because of thelikelihood of increased patient outcomes. The company facescompetition from other companies, which is a threat to its existencein the market.


Inan attempt to improve hand hygiene in the company, these threealternatives can be used education, making organizational changesand using feedbacks. The alternatives are discussed in the followingparagraphs.


Providinghealth care practitioners and patients with the appropriate educationcan be considered as one of the alternatives that the organizationcan utilize in enhancing hand hygiene. Some patients may not haveknowledge on how they should be handled by caregivers. Therefore,educating them will provide them with the understanding of how theyshould expect to be treated by the health practitioners (Perryet al., 2011).This being the case, they would make care providers stick to theright procedures in order to avoid queries and bad rating frompatients. There is a need to train caregivers on the importance ofadhering to the hand hygiene procedures so as to make them beconsistent with the initiative.


Theeducation strategy will have the advantage of making patients awareof the procedures that practitioners should follow while offeringcare. Also, the knowledge of patients would make caregivers moreaccountable. Moreover, the approach would help in improving handhygiene levels for the company.


  • The method will be costly

  • Not all the patients would understand what needs to be done

  • May not be effective since practitioners will have the final output


Theorganization may also opt to carry out feedback surveys, which it mayuse in understanding its level of hand hygiene (Zipperer,2016).The surveys may be conducted out involving employees of theorganization or even patients that visit the hospital. It is from theupdates that the company can come up with ways of upgrading theprocess.


  • The tactic can help the organization in understanding its pitfalls in the area of hand hygiene

  • The approach may be cheap since it may be carried online

  • The method does not require a lot of time


  • It may not be effective

  • The process may be biased

  • Although the approach may give the true picture of the situation in the company, it is not direct in improving hand hygiene

MakingOrganizational Changes

Anotheralternative that the entity can use is making changes in theorganization. In this case, the company may consider makingmodifications in areas, which it considers to be affecting the rateof conformity to the hand hygiene process (Waterson,2014).This alternative entails modifying the policies that guide anorganization in order to realize improvements in the process of handhygiene.


  • The approach can help employees to adhere to the procedure

  • The method can improve the process of hand hygiene effectively

  • The alternative can spread easily where employees do not resist change


  • The approach may face challenges due to resistance of change by employees

  • The alternative may require a lot of time to implement

  • The option may have an impact on other areas of an organization

Recommendationand Plan of Action

Thebest alternative that the company should choose is makingorganizational changes. This is the best alternative because thecompany’s policy is to blame for the low compliance rates. Theother two options cannot fully resolve the problem of the entity.Through the selected alternative, the problem statement would beresolved since the firm would come up with a policy that would ensuredisciplinary actions for non-conformity to the hand hygieneprocedure. The following is a timeline for implementation of theoption.



Discussion with Employees Concerning the Change to be Made

2 weeks

Feedback from Employees

2 weeks


2 weeks

Implementation Process

4 Months


Fromthe analysis, LHSC is faced with the problem of low levels of handhygiene process, which is necessary for preventing hospitalassociated infections. The problem that LHSC has, which iscontributing to the issue of low compliance rates to the hand hygienerequirement, is that it has no discipline mechanism for physicians aswell as other staff that can be followed for the failure of followinghand hygiene procedures. The best alternative that the company shouldchoose is making organizational changes since this would help inresolving the problem of the company. Therefore, LHSC needs to makean organizational change in order to improve hand hygienerequirement.


House,D. (2012). JustClean Your Hands.Ontario: Richard Ivey School of Business.

Kahan,S., Gielen, A. C., Fagan, P. J., &amp Green, L. W. (2014). Healthbehavior change in populations.Baltimore: Johns Hopkins University Press.

Perry,A. G., Potter, P. A., &amp Elkin, M. K. (2011). NursingInterventions &amp Clinical Skills.New York: Mosby.

Pittet,D., Boyce, J. M. &amp Allegranzi, B. (2016). Handhygiene: A handbook for medical professionals.Chichester, West Sussex, UK Hoboken, NJ: John Wiley &amp Sons.

Tweedy,T.J. (2014). HealthcareHazard Control and Safety Management,Third Edition. New York: CRC Press.

Waterson,P. (2014). Patientsafety culture: Theory, methods, and application.Farnham, Surrey, UK: Ashgate.

Zipperer,L. (2016). PatientSafety: Perspectives on Evidence, Information and Knowledge Transfer.London: Routledge.