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Using the TST FAQs

The Targeted Solutions Tool® (TST®) is a unique online application that simplifies the process for solving persistent health care quality and safety problems. Introduced in 2010, the TST was developed by the Joint Commission Center for Transforming Healthcare to enhance efforts that accredited organizations are making to tackle these difficult and pressing problems. The TST guides health care organizations through a step-by-step process to measure their organization’s actual performance, identify barriers to excellent performance, and direct them to proven solutions that are customized to address their particular barriers.

Contact TST Support with your name, organization name, organization location, and, if possible, your International Health Care Organization identification number (IHCO ID). JCI staff will respond to your email within two business days.

Participating health care organizations use process improvement methods to identify targeted solutions. First, they measure the problems with rigor. In many cases they learn that they are not doing as well as they thought they were. Then they identify exactly why the processes are failing, create solutions that address the most critical contributing factors, and prove the effectiveness of those solutions.

The TST is available to all JCI-accredited organizations. It can be accessed via JCI Direct Connect.

The Hand Hygiene module is targeted toward hospitals, but can be used by any organization where hand hygiene impacts patient care.

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No. The TST is available to all JCI-accredited organizations at no charge.

The TST provides the foundation and framework for an improvement method that, if implemented as directed, will improve an organization’s hand hygiene compliance and contribute to its efforts in reducing the frequency of health care-associated infections. The leading United States hospitals and health care systems that developed the hand hygiene solutions have achieved and continue to show major and sustained gains in hand hygiene.

In 2012 an international pilot with JCI–accredited organizations began and, although data are still being collected and analyzed, a 72 percent improvement in hand hygiene practices was reported.

No, there is no requirement to have Robust Process Improvement® (RPI®) expertise or experience. The TST is designed so that any health care professional can conduct a project, regardless of process improvement or project facilitation experience. The tool involves practical steps to improve processes and measure progress.

You can access the TST through JCI Direct Connect under the Resources tab.

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No. Organization-specific information will not be made public. It is confidential and for your organization’s use only. It will not be used in the accreditation process. Aggregated (de-identified) compliance information may be made available.

No. Any information entered into the TST is kept confidential and will not be used in the accreditation process. An accreditation surveyor has no way of knowing that an organization is using the TST unless the organization shares this voluntarily.

However, if an organization chooses to use TST work as part of its annual proactive risk assessment, then proof of use will be necessary.

No, using the TST is voluntary and self-paced.

The duration of a hand hygiene project varies from organization to organization. Unit-based projects have generally lasted from six to 12 weeks, depending on the resources and experience of the organization.

A core team of three to seven people is recommended.

The team should include a strong physician champion and a project leader to facilitate meetings and help gain buy-in from stakeholders. Include the manager of the pilot unit and people who work in the area, including ancillary staff, when appropriate (for example, housekeeping, lab, respiratory therapy). It is important to identify and involve the project stakeholders.

You will need to obtain management support for your project and assemble a project team. Project teams can be expected to spend up to four hours a week collecting and entering compliance data, attending team meetings, and implementing solutions during the first 12 weeks of the project. You can expect to spend four hours each month to sustain the gains achieved by the hand hygiene improvement strategies.

A project charter is a written document that defines the scope, team members, goals, and completion dates of the hand hygiene pilot project. The project charter is signed by the project team members as a demonstration of their support for the project and their agreement on the project’s goals and scope.

This observation was chosen as the method to determine baseline and post-solution hand hygiene compliance rates. However, it is nearly impossible to accurately observe hand hygiene compliance when washing occurs in a patient’s room. The Center decided to adopt the philosophy of “wash in/wash out” which directs health care personnel to wash their hands upon entry and exit from a patient’s room. This allows for accurate measurement, while still promoting the philosophy of washing before and after patient contact.

The concept of “wash in/wash out” describes a minimum number of times a health care worker should conduct hand hygiene when entering and exiting a patient’s room. If patient care necessitates the additional washing of hands (more than is required with “wash in/wash out”), this should be done in accordance with WHO, CDC, or other recognized hand-hygiene guidelines.

The TST does not measure hand washing compliance of patients and visitors. CDC and WHO guidelines are directed toward health care personnel only. The CDC definition of health care personnel excludes patients, family members, and other visitors, but does include students, volunteers, and other health care workers with direct patient contact. Studies have shown a greater risk of disease transmission from health care personnel compared to non-health care personnel such as patients and family members.

The TST does not assess procedures for disinfecting medical equipment or evaluate the impact of clothing of caregivers on transmission of infection. There are multiple factors that contribute to the effectiveness of infection prevention and control programs.

The TST works best with the following applications and settings. You may want to consult with your organization’s technical support before making changes to your computer or if you are unsure about your current settings.

Preferred Browser

Internet Explorer 7.0 or above. If you have earlier versions of IE, some features may not work.

Windows Requirements

Windows 2003 or above (XP, Vista, Windows 7)
Microsoft Office 2003 or above (for some downloads)
High-speed internet connection is preferred

Required Plug-ins

Adobe Reader 8 or above
Adobe Flash Player
Windows Media Player
Without these, you may not have access to videos or PDFs.

Supported Tablets



Older internet browsers may not display TST windows properly. Determine if your computer browser is Internet Explorer 7 or above; if it is not, contact your organization’s technology service department for a browser upgrade.

Send an email to TST Support with your name, organization name, and organization location. Staff will respond to your email within two business days.