Hand hygiene or sanitizing is one of those areas that continue to be with us, but it is not an easy one to measure to see if we are making progress. Sure we can do direct observation to try and see what people do and some organizations are using dyes in soap etc so they can scan hands. While these direct data collection measures are useful (and a great way to encourage accountability), they don't really give us an easy to manage indicator of our overall Hand Hygiene culture – including staff, physicians and visitors.

So let's consider another approach. What if we attempted to estimate our hand hygiene culture through an indirect measure? When we design data systems we look for the easiest way to get us as close to a useful answer as possible. So for hand hygiene culture let's consider the indirect measure of "Volume of Hand Sanitizer Used". Every time an employee, physician, patient or visitor squirts a little of that foam or gel into their hands, they are indicating support of your hand hygiene culture.