Marcel Walz (left) und Tobias Gebhard, Benjamin Heinzerling (right)


Protection against hospital germs

Patients become infected with pathogens as many as 700,000 times a year during a stay in hospital. These germs are transmitted through physical contact, among other things. GWA Hygiene GmbH uses artificial intelligence to monitor whether hospital staff disinfect their hands frequently and thoroughly enough.

Disinfection monitoring in clinics

GWA Hygiene develops intelligent sensors (KfW Bankengruppe/n-tv). This video is only available in German.

A strong wind whistles from the Baltic Sea around the Stralsund innovation centre and business incubator. Just four years after its formation, GWA Hygiene GmbH occupies nine rooms spread over three floors in the plain building. Maik Gronau, one of the founders, takes his visitors up and down the many stairs and through the corridors of the start-up with its 25 employees.

Hundreds of round Bluetooth-capable sensors have just been delivered to the warehouse. They were assembled in a Stralsund workshop for people with disabilities and can be attached to clothing. The white plastic piece is inconspicuous. But inside is a highly complex monitoring software application – artificial intelligence to optimise hand hygiene.

It collects data from disinfectant dispensers in hospitals. When the lever is pressed, the dispenser releases approximately 1.5 millilitres of liquid. The lever has to be pressed two or three times to thoroughly disinfect the hands. Fingertips, wrists, the spaces between the fingers. The attached sensor can detect how far the dispenser lever was pressed down and with how much force, making it possible to calculate the exact amount used.

Artificial intelligence

The Bluetooth-enabled sensors are assembled in a Stralsund workshop for people with disabilities and can be attached to clothing.

Maik Gronau explains how he came up with the idea for this development, which was christened “NosoEx” by the founding team of GWA Hygiene: “As a student I was in hospital and noticed how often the doctor disinfected his hands. He told me about the ‘five moments of hand hygiene’. They dictate exactly how often disinfection has to take place. Of course, mistakes happen. The only instrument available to analyse these mistakes, however, are the disinfectants purchased.”

Usually only the amount of disinfectant a facility purchased is compared with the patient days in the hospitals. A somewhat simple calculation, Gronau found, whose curiosity was sparked. He talked about it with a fellow student and future co-founder, Dirk Amtsberg. “The solution seemed obvious to us. It requires analysis software and sensors on the dispenser to determine an index of disinfection habits.” The analysis links the amount of disinfectant used to the mandatory number of times the dispenser lever is pressed.

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Their first rough design won an ideas competition at their university. Marcel Walz read about it on Facebook and invited the students to his flat. At the end of the evening, one thing was certain: we would have a closer look. “What I really wanted was to finish my degree quickly, get a job and start earning money. I had never thought about starting my own business before,” remembers Maik Gronau. Laughing, he adds: “But we had so much encouragement, we couldn't resist!”

Data security

Employees take any transponder from a box at the beginning of the shift and return it at the end of their working day. The data record inside the transponder cannot be traced to a single person.

A consultant makes the team aware of the EXIST start-up scholarship. This funding secures the first year of research. To test their idea, the founders equipped the entirety of Stralsund University with disinfection dispensers and a sensor system. They use the data collected to further develop their software. At the same time, they work on developing on a transponder for staff so that hand disinfection can be individually tracked.

“A data record cannot be traced to a single person, we would not support this kind of measurement. The employees take any transponder from a box at the beginning of the shift and return it at the end of their working day. The data is only tracked by occupation, for example, doctors wear blue tags and nurses wear green tags. It makes sense to record data by occupation because they perform different tasks. If a doctor only makes a brief visit, he has fewer disinfection processes to follow than someone who changes a bandage,” explains Maik Gronau.

Before data is collected, the NosoEx system is fed with the individual requirements of the facility being analysed. If, for example, a clinic has a ward with 500 beds, the disinfectant dispensers are counted as well as the occupancy of the patient rooms and the number of disinfections required – this can be higher in an intensive care unit than, for example, in a delivery room. This is all reflected in the software.

Founder: Maik Gronau, Marcel Walz, Dirk Amtsberg
New solutions

Maik Gronau (left) and his team are experimenting a lot, for example to equip mobile dispensers with sensors. The goal is to include all fixed and mobile dispensers in the analysis.

Customers obtain the analyses on the user-friendly system interface. Here they can see how many of the mandatory disinfections are performed properly. If the index is low, thought is given – often in consultation with GWA customer advisors– to how staff awareness can be improved. Training could be one measure.

The non-industry founders systematically align their solutions to the needs of the customer. It must be easy to integrate into everyday life and existing systems, it must be user-friendly and inexpensive. Today there are two sales channels: “We present our system to the hospitals and we cooperate with the disinfectant manufacturers. They are in a fierce price competition with one other and offer our solution as added value when selling their products,” explains MaikGronau.

The team of developers, engineers and economists has installed its product in 25 buildings not only in German-speaking countries, but also in Slovakia and Spain. Discussions with Portugal and Brazil are underway. At the same time, the software is constantly undergoing further development and new products such as a mobile disinfectant dispenser with integrated sensor are being developed. Financing through innovation programmes and KfW's European Recovery Program support guaranteed the first few years, and investors and other donors recently invested two and a half million.

“I became an entrepreneur more by accident. But a start-up like this one is cool! We are doing something here that is important and challenging at the same time. Turning a market upside down together is a lot of fun!” says Maik Gronau happily.

Published on KfW Stories: Tuesday, 9 April 2019


All United Nations member states adopted the 2030 Agenda in 2015. At its heart is a list of 17 goals for sustainable development, known as the Sustainable Development Goals (SDGs). Our world should become a place where people are able to live in peace with each other in ways that are ecologically compatible, socially just, and economically effective.