During a hospital-wide hand hygiene campaign in a teaching hospital in Geneva, Switzerland, hand hygiene compliance (HHC) was improved significantly from 47.6% (1994) to 66.2% (1997). In parallel the consumption of alcohol-based handrubs increased from 3.5 L to 15.4 L per 1,000 patient days, healthcare-associated infection prevalence was reduced from 16.9% to 9.9%, and transmissions of methicillin-resistant Staphylococcus aureus decreased from 2.16 to 0.93 episodes per 10,000 patient days.