Efforts to address poor provider hand hygiene rates have escalated in the setting of increased attention to health care–associated infections. Along parallel lines, the importance of patient engagement was elevated by its introduction into the National Patient Safety Goals. This pilot study adopted a tool to engage patients in auditing provider hand hygiene rates in the ambulatory setting. Investigators found that patients were largely willing to monitor and report on providers' compliance with hand hygiene and did not feel it impacted their patient–provider relationship. Patient observations correlated well to independent direct observations of hand hygiene rates, suggesting that this type of engagement may be efficient and acceptable.