In an observational study conducted by Memorial Hermann Health System (MHHS), researchers found that hand hygiene compliance is the key to preventing hospital-acquired infections. This study was designed to implement a new research strategy called Targeted Solutions Tool (TST). It was put in place throughout 12 hospitals and with 150 inpatient units. The researchers were conducting the study to determine compliance for hand hygiene. The TST was used to determine the minimum number of times a day a nurse is supposed to wash their hands when entering or exiting a patient’s room, “wash in / wash out” phase. Unbiased employees were selected to be observers and were trained on how to collect accurate data. As well, “Just in Time” (JIT) coaches, who are completely unknown to the caregivers, watch for hand washing compliance and interfered if they found a staff member who was out of compliance. Based on the findings, TST allowed MHHS to look at compliance rates, identify reasons for noncompliance, implement tested interventions provided, and sustain the improvements. Only secrete observers data was used to determine the rates of noncompliance. The data that was collected and analyzed was specific to intensive care unit (ICU), central line associated bloodstream infection (CLABSI) and ventilator associated pneumonia (VAP). In conclusion to the study, MHHS improved hand hygiene compliance and sustained high levels of compliance for 25 months following. More specifically hand hygiene levels rose from just 58.1% at the baseline rate to 95.6% during the final months of the program, and ICU, CLABSI, and VAP rates decreased from 49% to 45%.