Hand hygiene is critical to prevention of health care–associated infections. Despite intensive efforts, hand hygiene is not practiced universally in clinical settings. This systematic review sought to evaluate the effectiveness of patient-focused interventions to enhance adherence to hand hygiene practices. Researchers examined studies aimed at encouraging patients to remind health care providers to wash their hands. Because of the limited number and quality of current studies, researchers were unable to draw firm conclusions. Encouragement from health care providers seemed to be an important predictor for success in empowering patients to speak up about hand hygiene concerns. The authors recommend conducting more methodologically rigorous studies in order to determine the impact of patient-focused initiatives to promote hand hygiene. A recent AHRQ WebM&M perspective discussed strategies to enhance hand hygiene compliance.