Issue Healthcare workers' compliance with hand hygiene is very important in preventing and controlling the transmission of infections. Data from daily hand hygiene audits was analyzed and indicated that the hospital compliance rates were lower than the Ontario provincial average. Project The "Wash to Win" rewards program was initiated to bring about behavioural and cultural change in order to sustain improved hand hygiene amongst staff. All inpatient units and emergency departments that met and sustained hand hygiene targets for two consecutive months won either an iPAD™ or $500. Phase I ran from May 2012 to September 2012 and targets were 75% and 80% for "before patient/patient environment contact" and "after patient/patient environment contact" respectively. Phase II ran from October 2012 to December 2012 and targets were 85% for "before patient/ patient environment contact" and 95% for "after patient/patient environment contact." The program was implemented with regular staff education, daily auditing and monthly circulation of compliance rates to staff, unit managers and senior leadership. Results Hand hygiene compliance increased from 73% to 85% for "before initial patient/ patient environment contact" and 86% to 95 % for "after patient/patient environment contact" during the eight-month campaign. Since the end of the program, the increase has been sustained. Lessons learned Positive reinforcement does change people's behaviour. Rewards were most effective when they were delivered immediately after the change in behaviour. In retrospect, targets would 100% for both "before and after patient/patient environment contact" at the onset of the program. The program would also be extended until targets were maintained consistently for 1 8-24months.