System change is a vital component of the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy for all health-care facilities.
This refers to ensuring that the necessary infrastructure is in place to allow health-care workers to practice hand hygiene. Without key improvements here, the other Multimodal Strategy components are not immediately relevant.
In the ideal situation, the necessary infrastructure for health-care facilities means they will have sinks for handwashing, complete with a safe, continuous water supply, soap and towels available in each room as well as alcohol-based handrub available at every bed.
System change will be particularly important for health-care facilities at the early stages of hand hygiene improvement, where there may be low awareness amongst health-care workers of the importance of hand hygiene and inadequate infrastructure to support this. However, it can also be important for all health-care facilities to revisit System Change at key intervals.