3
Hand Hygiene
Methods for Measurement
Table 1. Methods for Measurement
Method Input data Output
Frameworks and
examples Notes
Statistical
Process
Control
Events per
period
Mean or
median of the
event rate/
occurrence
• Model for
Improvement
• Lean
• Six Sigma
Based on
identifying
deviations
from a baseline
value, requires
construction of
event definition,
access to data
(e.g., patient days,
vascular catheter
days, etc.)
Qualitative Interviews,
focus-group
transcripts,
testimonials
emes
related to
beliefs,
practices,
perceptions
• Theoretical
Domains
• Replicating
Effective
Practices (REP)
• Can help guide
project target/
focus
• Can test
pre- and post
intervention
effectiveness
• Open-ended
nature allows
probing
• More labor
intensive to
analyze
Surveys Answers to
questions on
an existing
or de novo
survey
• Descriptive
data (e.g.,
practices)
• Association
testing
• Behavior Change
Wheel (BCW),
that includes
the COM-B
(Capability,
Opportunity, and
Motivation to
change Behavior)
• Theoretical
Domains
Subject to pitfalls
and bias
Delphi Degree of
agreement
with
statements
or practices
Multiple
rounds of
ranking and
feedback of
results until
consensus
reached
Bright STAR,
used for quality
improvement/
implementation
An organized
method to reach
consensus for
practices without
high-quality
evidence
Mixed
Methods
Quantitative and qualitative or survey data
