The Broken System: How Your Organizational Culture Is Hurting Your Progress (Especially in Infection Prevention)

When infection prevention and control (IPC) is treated like a checklist item, it leads to waste, burnout, and missed opportunities for real improvement. I’ve seen how a misaligned approach to IPC can turn a potential strategic advantage into a burden and how small, intentional changes in leadership engagement and program structure can create measurable results. 

A Case That Might Sound Familiar 

In one healthcare setting, I was involved in assessing and leading the change for a struggling hand hygiene program. On the surface, everything looked great: hand hygiene data was being collected, metrics were tracked, and updates were shared during safety huddles and IPC-related committee meetings. 

But when I took a closer look at the full picture, here’s what I found: 

• One infection preventionist was tasked with overseeing the entire hand hygiene program across a hospital and multiple clinics. 
• Over 20 nurse leaders were spending more than 10 hours a week collecting hand hygiene data on top of their leadership responsibilities. That added up to more than 40 hours per month, representing an estimated minimum of $52,500 per month in salary expenses that could have been better directed toward their core strategic roles. Annually, that’s over $600,000 in workforce time redirected away from mission-critical priorities.  
• Hand hygiene data were collected in large volume but not used efficiently to make any improvements in patient care. It was shared with noncompliant units as a generic reminder “to do better” without a concrete plan for improvement. 
• Hand hygiene compliance was tracked to meet external benchmarks such as Leapfrog ratings, not with a focus on improving the quality of care or staff engagement. 

What Changed 

By partnering with unit-level and senior leaders, I helped realign the program with a different approach: 

• We engaged unit and senior leaders to become strong advocates for infection prevention and position IPC as a shared responsibility and part of daily operations, not a side project.  
• We identified eager, capable team members to serve as hand hygiene champions based on their availability, passion for IPC, and influence in their respective departments, regardless of their title. 
• We redistributed data collection and accountability from overwhelmed nurse leaders to a team of 2–5 champions per department, including frontline nurses and members of support services staff who hadn’t previously been involved in IPC initiatives. 
• We launched quarterly coaching, incentive structures, and encouraged patient and family engagement with hand hygiene initiatives and more meaningful leadership to build momentum and sustain the program’s outcomes as a long-term strategy. 

The Outcomes 

• Nurse leaders gained back over 40 hours per month to refocus on strategic goals and team development, redirecting salary expenses to priorities closely aligned with their leadership roles. 
• Frontline staff, not only nurse leaders, felt more engaged, supported and empowered, reinforcing the organization’s commitment to a culture of safety. 
• Hand hygiene stopped being a compliance checkbox and became a true part of the safety culture from senior leadership to all frontline workers. 

This Isn’t Just About Hygiene, It’s About Strategy 

As in this organization’s example, when IPC is integrated into your organizational goals, you see better outcomes and results go far beyond compliance: 

• Teams become more efficient 
• Stronger systems are established 
• Fewer compliance gaps are identified 
• Leadership is more aligned with strategic priorities 
• Staff burnout is reduced 
• Significant cost savings are achieved  

Is your IPC program helping your organization move forward or just helping you get by? 

This is an opportunity to take a closer look at what’s working and what’s getting in the way of your organization’s success.  

If you missed it, here’s a related article showing exactly how to achieve success with a culture shift: Beware of the “I Know It All” Syndrome: The Hidden Cost of Silos in Infection Prevention