Hand hygiene is the foundation of effective infection control in health care settings, including in areas designated for blood collection. However, in such areas, patients are assigned in rapid succession and hand hygiene can lapse due to time pressure. Therefore, we examined a more efficient hand hygiene technique with consideration of these time constraints. An infection control issue was noted during a blood test procedure, based on Kiken Yochi Training. Meetings were then held to discuss the issue and a study was proposed to test a more efficient hand hygiene technique as a solution. The hand hygiene technique involved (1) performing hand hygiene after glove removal, (2) wearing gloves just before directly touching the patient, and (3) concentrating on the finger and hand areas involved in glove removal when performing hand hygiene using a rapid-drying hand disinfectant. These three items were compared before and after the change of procedure using a rapid-drying hand disinfectant. The results confirmed that it is possible to practice efficient hand hygiene by recognizing the areas of the hand that are contaminated during the blood collection procedure. Difficulties involving hand hygiene in a blood collection area include thoroughness in using one glove for one patient and time constraints. We suggest that performing effective infection control is possible by unifying the timing of appropriate hand hygiene with the timing of blood collection.

At Anjo Kosei Hospital, all staff has been working concertedly on a project to establish a community hospital in line with our future vision. Hospital staff in charge of the Medical Affairs Division has been involved in measures aimed at achieving the slogan “health and happiness of local residents” as part of this project. To address this, three goals were set as follows: improvement of recoveries in accounts receivable management, a reduction of money held in trust, and a decrease in the number of outsourced transactions. To achieve the goals described above, the following specific measure were carried out: (1) collection of accounts receivable using convenience store settlement; (2) collection of high-cost medical expenses by wider use of Eligibility Certificates for Ceiling-Amount Applications and promotion of the Major Medical Cost Loan System for national health insurance holders; and (3) support in acquiring family registration for nonregistered family members and for health insurance benefits. Recoveries of accounts receivable through convenience store settlement was about 90,000 yen/month, and our support activities for family registration and health insurance benefits provided the recoveries of about 80,000 yen/month. Furthermore, the promoted use of the certificate and loan system resulted in recoveries of about 17 million yen/year. The average commission fee and number of outsourcing was 890,188 yen and 12 cases, respectively, from April to August 2016. However, in 2017, it was 305,615 yen and 10 cases, respectively. Our project aimed at achieving slogan-elicited patient voluntary payment of medical expenses, leading to improved recoveries, with reduced money held in trust and fewer outsourced transactions.