Achievements of WHO's First Global Patient Safety Challenge (1st GPSC)

Background: The 1st GPSC "Clean Care is Safer Care" (CCiSC) patient safety program from 2005 to 2009 aimed to support the reduction of healthcare-associated infections (HAI) worldwide through hand hygiene (HH). Three objectives were defined: 1) raise global awareness on the importance of HAI; 2) galvanize political commitment by Member States; 3) promote best practice at the point of patient care. To achieve these, actions included: 1) networking with international experts and stakeholders; communications including publications; educational activities at national and international levels; 2) invitations to Ministries of Health (MoH) to sign a formal statement as a pledge of their commitment to tackle HAI; 3) development and dissemination of guidelines and technical tools. The global, annual initiative, "Save Lives: Clean Your Hands", was also launched on 5 May 2009 to support long-term HH improvement.

Objective: To describe overall awareness in countries and individuals; to assess program feasibility and reliability through testing of a HH improvement strategy in pilot sites and additional "test" health-care settings.

Methods: Monitoring of country activities and individual commitment were undertaken through communications and electronic surveys. WHO's multimodal HH improvement strategy was evaluated in eight pilot sites identified from WHO regions, by providing a protocol, a named individual focal point and data analysis tool. Data were submitted and analysed during 2008-09. Further, an on-line questionnaire and semi-structured interviews were utilized to gather data from registered "test" health-care settings.

Results: Pledge signatures were received from 121 (63%) MoH. Country commitment has been reflected in the launch of 38 national/sub-national HH campaigns. Two surveys on country activities have been published, with two meetings held to support sharing of strategies. As of 31 October 2009, 5,801 hospitals from 125 countries have registered for the "Save Lives: Clean Your Hands" initiative. Significant increase in HH compliance was observed across all pilot sites, as well as improvement in infrastructure to support HH and in health-care workers' perception and knowledge on the importance of HAI and HH. Of 114 (35%) responsive "test" health-care settings, 47 (41%) were interviewed and concurred that all five components of the multimodal strategy were essential. The production of WHO's alcohol-based handrub formulation was also reported in eleven sites worldwide demonstrating feasibility and cost effectiveness.

Conclusions: Within four years, the 1st GPSC has generated unprecedented global momentum by mobilizing countries and individuals to support its overall aim. Preliminary data supports the benefits of a global patient safety program. By making IC a priority in health-care, with HH as its solid and essential basis, 1st GPSC efforts have had the potential to enhance patient safety worldwide.