After rates of compliance on hand hygiene declined from 2009 to 2010, Sycamore Shoals Hospital in Johnson City, Tenn., created a Hand Hygiene Team to scrub the facility's policies and practices. That team, in turn, launched the Bugs Under Medical Management to Eliminate Resistance program to remind everyone to wash their hands.

The team provided staff evidence-based educational tools and increased access to hygiene products. After setting an initial goal of 90% compliance, rates rose from 76.9% in late 2010 to 100% by spring 2011. Those results have earned 79-bed Sycamore Shoals the Honorable Mention in the Spirit of Excellence Team category.