A systematic approach for the location of hand sanitizer dispensers in hospitals

• Published in: Health care management science 2014-09, Vol.17 (3), p.245-258
• Main Authors: Cure, Laila, Van Enk, Richard, Tiong, Ewing
• Format: Article
• Language: English
• Subjects: Alcohol; Alcohols; Business and Management; Cleaning compounds; Compliance; Computer Simulation; Cost control; Data collection; Econometrics; Ergonomics; Guideline Adherence; Hand Disinfection - instrumentation; Hand Sanitizers; Hands; Health Administration; Health Informatics; Hospitals; Humans; Hygiene; Intervention; Management; Nosocomial infections; Operations Research/Decision Theory; Optimization; Patient safety; Practice Guidelines as Topic; Sanitizers; Statistical analysis; Systems Analysis; Usability; Workflow
• ISSN: 1386-9620; 1572-9389
• DOI: 10.1007/s10729-013-9254-y

Compliance with hand hygiene practices is directly affected by the accessibility and availability of cleaning agents. Nevertheless, the decision of where to locate these dispensers is often not explicitly or fully addressed in the literature. In this paper, we study the problem of selecting the locations to install alcohol-based hand sanitizer dispensers throughout a hospital unit as an indirect approach to maximize compliance with hand hygiene practices. We investigate the relevant criteria in selecting dispenser locations that promote hand hygiene compliance, propose metrics for the evaluation of various location configurations, and formulate a dispenser location optimization model that systematically incorporates such criteria. A complete methodology to collect data and obtain the model parameters is described. We illustrate the proposed approach using data from a general care unit at a collaborating hospital. A cost analysis was performed to study the trade-offs between usability and cost. The proposed methodology can help in evaluating the current location configuration, determining the need for change, and establishing the best possible configuration. It can be adapted to incorporate alternative metrics, tailored to different institutions and updated as needed with new internal policies or safety regulation.