Hand Hygiene Observation App

How I helped 500+ clinicians stop using paper forms and actually track hand hygiene

Infection preventionists were tracking hand hygiene observations with clipboards, typing everything twice, while admins made went hopscotching for compliance data.

I redesigned the Hand Hygiene system and launched its first mobile app that killed the paper trail and got real-time compliance data flowing to the people who needed it.

My role

UX Designer

Team

4 Fullstack Engineers, 3 Data Analysts, 1 Product Manager, 1 Product Owner

Timeline

6 months

Outcomes

0%

Faster observations

0%

Faster data uploads

50%

Error-free submissions

What went wrong?

Clipboards and chaos in every hospital unit

Picture an infection preventionists tracking 50+ hand hygiene moments per shift. Clipboard. Pen. Then typing it all into a clunky 2015 web app hours later.


The waste was staggering:


  • Every observation recorded twice

  • Errors everywhere (Is that a 5 or an S?)

  • Admins making decisions on week-old data

"I spend more time typing than observing."— Inpatient Observer, CCHMC

The kicker? Bad hand hygiene literally kills people. We're talking about preventing hospital-acquired infections. And we're tracking it with clipboards.

Old hand hygiene observations flow

(paper → old legacy app)

THE BREAKING POINT

When compliance audits met reality

Joint Commission visit coming up. Leadership wanted real-time data.

An Inpatient observer told me she had three weeks of observations in her locker. Just sitting there. Unrecorded.


That's when they called me in:

  • Digitize the observation workflow

  • Build something people would actually use

  • Get real-time compliance data flowing


Six months. 500+ users. Zero room for failure.

Challenge Accepted!

my approach

Getting the real story from the people living it

I couldn't shadow every shift, but I could ask the right questions. So I conducted targeted interviews and quick surveys with observers and unit admins.


Three things became crystal clear:

Problem 1: Two hands,

three items

They needed clipboard, pen, and sanitizer. But humans have

two hands. Math problem.

Problem 2: Double work

Write it down. Type it up. Waste of skilled preventionist time.

Problem 3: System hopscotch

Admins jumping between systems for compliance data.


The insight: Stop making infection preventionist work like data clerks. Design for how they actually move.

user testing

Three attempts to get it right


I sketched out different approaches and watched observers try to give us better data capture. The first two versions taught me exactly how not to design for healthcare.

V1: Too clever
Added autofill. Created duplicates everywhere. Preventionist panicked.
V2: Too much
Everything in one screen. Watched an infection preventionist almost throw the tablet.
V3: Just right
Followed their exact workflow. One or multiple observations → One screen → Next.
The solution

Three changes that fixed everything

Solution 1: Workflow that actually flows

Redesigned web app workflow before (old legacy app) / after redesign (V3)


Result: 35% faster uploads. 100% error-free at launch.

Before (old legacy app)
Confusing navigation
No in-line validation to catch errors
Looked like Windows XP
After (V3)
Followed their exact workflow. One or multiple observations → One screen → Next. One tap. Next.
Clear progression matching their mental model
Modern interface they could trust
solution 02

Real-time speed without losing data quality

The mobile experience was designed for one hand and motion:


  • Large touch targets (reduce mis-taps)

  • Progressive disclosure (only show what's needed)

  • One-handed operation

  • Offline save with auto-sync


Resulting in finished rounds 20 minutes early. 40% faster recording compared to manual paper recording.

No more carrying around clipboards!

solution 03

Embedded Power BI directly into their existing workflow

We embedded Power BI dashboards directly in the product with unit views and time trends. 


  • Live compliance rates

  • Unit breakdowns

  • Zero lag


As a result, admins no longer had to switch between systems giving them instant visibility into unit-level trends and progress.

reports redacted due to privacy.

Retrospective

The Slack message that made it worth it

Six weeks after launch, I got a message from an Infection Preventionist:

Ellen Ecker12:34 PM
Hey Manny, just finished rounds. Used to take 90 minutes with the old system. Did it in 50 last night. That's 40 minutes back with my patients. Thank you for your work on this!

Every second we save them is a second they can spend on care. Every error we prevent might prevent an infection. Every dashboard we build helps them see problems before they become tragedies.


The truth? I thought I was building a data collection tool. I was actually building time. Time for infection preventionist to be infection preventionist. Time for admins to make informed decisions in a timely manner and time that might save someone's life.


And yeah, I definitely did more than a small victory dance when we hit 100% adoption.

Hand Hygiene Observation App

How I helped 500+ clinicians stop using paper forms and actually track hand hygiene

Infection preventionists were tracking hand hygiene observations with clipboards, typing everything twice, while admins went hopscotching for compliance data.

I redesigned the Hand Hygiene system and launched its first mobile app that killed the paper trail and got real-time compliance data flowing to the people who needed it.

My role

UX Designer

Team

4 Fullstack Engineers, 3 Data Analysts, 1 Product Manager, 1 Product Owner

Timeline

6 months

Outcomes

0%

Faster observations

0%

Faster data uploads

50%

Error-free submissions

What went wrong?

Clipboards and chaos in every hospital unit

Picture an infection preventionists tracking 50+ hand hygiene moments per shift. Clipboard. Pen. Then typing it all into a clunky 2015 web app hours later.


The waste was staggering:


  • Every observation recorded twice

  • Errors everywhere (Is that a 5 or an S?)

  • Admins making decisions on week-old data


The kicker? Bad hand hygiene literally kills people. We're talking about preventing hospital-acquired infections. And we're tracking it with clipboards.

"I spend more time typing than observing."— Inpatient Observer, CCHMC

Old hand hygiene observations flow (paper → old legacy app)

Magnifiable image
Magnifiable image
THE BREAKING POINT

When compliance audits met reality

Joint Commission visit coming up. Leadership wanted real-time data.


An Inpatient observer told me she had three weeks of observations in her locker. Just sitting there. Unrecorded.

That's when they called me in:

  • Digitize the observation workflow

  • Build something people would actually use

  • Get real-time compliance data flowing


Six months. 500+ users. Zero room for failure.

Challenge Accepted!

my approach

Getting the real story from the people living it

I couldn't shadow every shift, but I could ask the right questions. So I conducted targeted interviews and quick surveys with observers and unit admins.


Three things became crystal clear:

Problem 1: Two hands,

three items

They needed clipboard, pen, and sanitizer. But humans have

two hands. Math problem.

Problem 2: Double work

Write it down. Type it up. Waste of skilled infection preventionist time.

Problem 3: System hopscotch

Admins jumping between systems for compliance data.


The insight: Stop making infection preventionist work like data clerks. Design for how they actually move.

user testing

Three attempts to get it right


I sketched out different approaches and watched observers try to give us better data capture. The first two versions taught me exactly how not to design for healthcare.

V1: Too clever
Added autofill. Created duplicates everywhere. Preventionists panicked.
V2: Too much
Everything in one screen. Watched an infection preventionist almost throw the tablet.
V3: Just right
Followed their exact workflow. One or multiple observations → One screen → Next.
The solution

Three changes that fixed everything

Solution 1: Workflow that actually flows

I redesigned the entire web app workflow from scratch.


Result: 35% faster uploads. 100% error-free at launch.

Before (old legacy app)
Confusing navigation
No in-line validation to catch errors
Looked like Windows XP
After (V3)
One or multiple observations → One screen → Next
Clear progression matching their mental model
Modern interface they could trust
Solution 2: Mobile built for motion

Real-time speed without losing data quality

The mobile experience was designed for one hand and motion:


  • Large touch targets (reduce mis-taps)

  • Progressive disclosure (only show what's needed)

  • One-handed operation

  • Offline save with auto-sync



Resulting in finished rounds 20 minutes early and 40% faster recording compared to manual paper recording.

No more carrying around clipboards!

Solution 3: Dashboard where admins live

Embedded Power BI directly into their existing workflow

We embedded Power BI dashboards directly in the product with unit views and time trends. 


  • Live compliance rates

  • Unit breakdowns

  • Zero lag


As a result, admins no longer had to switch between systems giving them instant visibility into unit-level trends and progress.

reports redacted due to privacy.

Retrospective

The Slack message that made it worth it

Six weeks after launch, I got a message from an Infection Preventionist:

Ellen Ecker12:34 PM
Hey Manny, just finished rounds. Used to take 90 minutes with the old system. Did it in 50 last night. That's 40 minutes back with my patients. Thank you for your work on this!

Every second we save them is a second they can spend on care. Every error we prevent might prevent an infection. Every dashboard we build helps them see problems before they become tragedies.


The truth? I thought I was building a data collection tool. I was actually building time. Time for infection preventionist to be infection preventionist. Time for admins to make informed decisions in a timely manner and time that might save someone's life.


And yeah, I definitely did more than a small victory dance when we hit 100% adoption.

Next project.
Next project.

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