At my last hospital, we struggled to find effective and efficient ways of monitoring and managing hand washing compliance, because it can significantly reduce Hospital-Acquired Infections(HAIs). But, the answer may now come from something I saw on the exhibit floor at HIMSS, Ekahau has a really cool technology for all of my Environment of Care friends. The Infection Control Solution uses wireless technology to track the location and staff interactions with patients and measures hand hygiene activity down to the individual caregiver. This means supervisors can check to see if an employee or physician washed their hands after completing a patient encounter. This information can then be used in job performance assessments. 
I think most job descriptions (and the rules and regulations of medical staffs) include something along the lines of “complies with hospital policies”. If your policy then states that employees and medical staff members must wash their hands between patients then you are set for monitoring. Let me know if you think this will be helpful or if you are already using this technology.