Introduction
In 2009, the Ministry of Health and Long-Term Care mandated Ontario hospitals to begin reporting compliance for the four moments of hand hygiene. Rouge Valley Health System (RVHS) discovered it had very poor baseline results (2008–09): 40% for the first moment and 51% for the fourth moment. RVHS responded by making hand hygiene compliance a corporate priority, with the goal of attaining sustained hospital compliance rates of >90% for the first and fourth moments. To achieve this, RVHS put into action its Hands Up strategy.