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The campaign -- which includes hiring hand hygiene monitors to roam hospital halls and educate doctors and nurses who don't properly wash their hands, and billboards, screensavers and tough posters such as one that shows a child in a hospital bed and warns, "You Could Kill Him With Your Bare Hands"

-- is in its third year, despite early discomfort by some hospital staff and the risks involved in such directness.

Novant had always used the traditional resources for hand hygiene education that many hospitals in America use today, but it was obviously not enough because it never changed behavior, according to Jim Tobalski, senior vice president of marketing and communications at Novant Health. Tobalski was charged with spearheading the employee educational campaign and helping the clinical team improve hand hygiene compliance. He admits that he initially had no idea how to accomplish the goal.

"The project was huge, but I knew to be successful, we had to scrap what I refer to as the traditional 'Mr. Scrubby Bubbles' approach and do something totally different," said Tobalski, a Seinfeld TV show fan whose ultimate decision to follow Seinfeld character George Costanza's example and "do the opposite" paid off.

Novant's two-year results come at a time when a new survey by the Association for Professionals in Infection Control and Epidemiology shows most infection-prevention professionals don't believe hospitals are doing enough to ensure proper hand hygiene. In addition, the Centers for Disease Control recently updated estimates of healthcare-associated infections to 1.7 million infections and 99,000 associated deaths in U.S. hospitals each year.

Estimated 40 - 50 Percent of Hospital Workers Wash Hands Properly

"When we began our campaign, it was estimated that only 40 - 50 percent of hospital workers nationwide washed their hands properly," said Wiles. "That's unacceptable. We must all create
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