Jake L. Muller Principal Software Engineer

Clinical · Garnet Health · 2022

Hand Hygiene Capture

Real-time capture of hand hygiene events that moved a hospital-wide safety metric far enough to earn an external compliance designation.

  • RoleArchitect and lead engineer
  • Year2022
  • StatusIn production
  • C#
  • ASP.NET MVC
  • MS SQL Server
  • JavaScript

How it works

In order: Capture point; Event stream; Audit ledger; Unit dashboard.CAPTURE POINT01EVENT STREAM02AUDIT LEDGER03UNIT DASHBOARD044 STAGES, LEFT TO RIGHTIn order: Capture point; Event stream; Audit ledger; Unit dashboard.01CAPTURE POINT02EVENT STREAM03AUDIT LEDGER04UNIT DASHBOARD4 STAGES, IN ORDER
What this shows

Events are captured at the point of care and written straight to an audit ledger. Nothing is inferred from proximity, which is what made it survive survey.

  1. 01 · The problem

    Hand hygiene compliance was measured by people with clipboards. The numbers arrived weeks late, covered a sample rather than a census, and changed behaviour on the days observers were visible. Infection prevention needed a measurement they could act on inside a shift, and the hospital needed something that would hold up in front of a surveyor.

  2. 02 · What I decided

    I argued against buying a badge-and-beacon product. The vendor systems measured proximity and inferred behaviour, which is exactly the kind of derived number a surveyor questions. We built direct event capture instead, wrote the event model first, and designed the audit trail into the schema on day one rather than reporting on top of it later.

  3. 03 · The outcome

    Hospital-wide compliance rose far enough that DNV recognised it during survey. The event stream now feeds unit-level dashboards, and the audit trail answers the retention question without anyone assembling a spreadsheet.

Anatomy

What a surveyor, or a hiring panel, should hear.

01

Constraint

Observers changed behaviour on the days they were present, and sample rates could not survive a surveyor who asked for the census.

02

Decision

Direct event capture over badge-and-beacon inference, with the audit trail designed into the schema on day one.

03

Ownership

The hospital owns the event model, the retention policy, and the unit dashboards. No vendor holds the compliance record.

Designation
DNV
Uptime
99.9%
Platforms
Web