Objective: To assess the impact on adherence to hand hygiene after implementing the World Health Organization (WHO) multimodal strategy at Hospital San Rafael de Facatativa. Methodology: The multimodal hand hygiene strategy was implemented from June 2012 to April 2013, constituted by 5 phases. Adherence was measured before and after the intervention by undercover observers, which made a minimum of 200 observations in every ward included. Results: An initial hand-hygiene adherence percentage of 34.27% was observed, which increased to 54.16%. An increase in adherence was observed in all services and professional groups assessed. Increased adherence was observed in pre-intervention phase at handwashing moments 1 (39%) and 2 (48%) compared to moments 3 (42%) and 4 (36%). Moment 5 showed the lowest adherence (18%). Adherence was higher in the post-intervention phase at moments 3 (72%) and 4 (64%) compared to moments 1 (55%) and 2 (55%). An increase in adherence was observed for moment 5 (37%). Conclusions: An increase in adherence to hand hygiene was achieved in all services and professional groups assessed after multimodal strategy implementation at the institution. Although adherence frequency is within proportion reported by other studies, different measures should continue to be implemented to further improve.