But, for many, the pain is not. No one enjoys the thought of getting a shot, and Risk and Quality Managers also wince at the need to track their organization’s vaccination screening compliance – most systems are a hassle. There’s no need to worry anymore.
We’ve taken the pain out of compliance tracking with our easy-to-use Influenza Vaccination Screening Compliance Worksheet addition to ActionCue Clinical Intelligence.
Although the rates of infection have steadily decreased over the past few years, still approximately 75,000 deaths were attributed to hospital-acquired infections in 2011, according to the Centers for Disease Control and Prevention.
There are measures that can be taken to lower infection rates which are surprisingly easy.
Red blood cell (RBC) transfusion strategies are a common treatment in the U.S. But, infection rates dropped by 20 percent when hospitals performed them less often.
It is the simplest one on the list, and a shock that it even needs to be on here. Yet, a large enough portion of healthcare workers resist the practice that it bears constant reminding.
This is a shameless plug because it works. Other industries have adopted information technologies to dramatically improve their quality, Healthcare is no different.
A study at Case Western Reserve University School of Medicine found that a dedicated and educated housekeeping team reduced room infection by 89% of baseline.
A study published in the May 2013 issue of Infection Control and Epidemiology found that copper surfaces reduced the amount of health care-acquired infections by more than half.
I didn’t until I wrote this article. Find out more information by visiting the globalhandwashing.org website.
Hospital CEOs today bare an enormous weight of increasing healthcare quality and performance, while at the same time reducing costs. It is an overwhelming task for even seasoned healthcare executives — one that is made more difficult for many new CEOs who are just starting out and are battling age, and experience gaps.
In an exclusive interview with FierceHealthcare, Nicholas R. Tejeda, CEO of Doctors Hospital of Manteca (Calif.), a 73-bed facility affiliated with the Tenet Healthcare Corporation, talks about his own experience with experience-related perceptions, and offers some excellent leadership advise to hospital executive who find themselves in similar situations.
In the article, Tejeda offers this:
Though his comments were in response to issues facing younger executives, this is excellent advice, regardless of age or experience level. Engaging with staff to learn, and build trust is more important now than ever before.
With the number of changes and demands on healthcare facilities from both insurances and government entities, hospital staff is increasingly overwhelmed, and look to their leadership to chart a course through to calmer seas and better patient care. To help get there, CEOs should be willing to look for the insight and experience of their staff.
Have you heard the news? Nurses want to spend more time with their patients. Let’s see… it’s 2014 and we are still challenged with an issue that has been around since I was in nursing school (for reference, telephones all had cords back then). Healthcare is bursting at the seams with news of nurses wanting more time with patients, patients wanting more time with nurses, and concluding that when the twain shall meet, good things happen like infection rates go down, fall rates go down, and patient satisfaction goes way, way up [ http://on.wsj.com/1nZTwcM ]. That’s not the only tale we continue to tell. There is also the one about the franken-nurs
e, the Quality-Risk-CaseManager-Chief Nursing Nurse with so many roles that she feels at a loss to authentically attend to any one of them unless led there by crisis.
Needs are identified across industries all the time, and they promote innovation and solutions – the mother of invention kind of thing. What would happen in the Communications industry if consumers expressed the need to interact with each other in real time? Guess what? It happened. Innovations galore – like Skype™, instant messaging, etc. – swept in to fill the gap created by the need. I haven’t read an article in a decade about people pining away for lack of online social connectivity.
Healthcare has done some great things and is now in a period of unprecedented evolution. So, now is a good time to fix long-standing process deficiencies (cultural deficiencies?) that keep patients and nurses from getting what they want.
I came across an intriguing article by Henry Doss about design thinking and its inspiring application to a problem identified by a healthcare clinic [ http://onforb.es/1jNuUHR ].
Venice Family Clinic in California was going to open a new clinic. Not only did the site require bricks and mortar construction, but they also took advantage of the opportunity to re-design how the
y did everything from patient check-in, to patient experience. And, of course, any process changes had to be efficient and lower costs. When this idea was proposed to the hospital team – control costs while achieving high quality outcomes – it sounded like a contradiction in terms.
The clinic administrators reached out to a design thinking company to jump start the creative process. Once in motion, the hospital team itself discovered their own inherent ability to think and create in a way that they hadn’t before. They asked these simple questions to begin with: “Should there be a check-in desk taking up most of the lobby? Should thirty waiting patients be funneled through six reception windows to receive care in the twenty-two available exam rooms? Must the patients be left idle while they wait for care? Is there a better way to use the clinic space and the patients’ time?” The clinic team was then shown how pit crews at auto races manage time and maximize efficiency. This led to the idea that someone with an iPad or similar would walk up and greet each patient as they arrived. Mobilize staff to go to the patient to avoid wait times. Thank you, pit crew. Other innovations were born as the team at Venice Family Clinic was handed a moment of creative confidence that isn’t usually a part of the milieu.
Challenges like nurses being buried in too many managerial roles and needing to spend more time with patients continue to play out in every healthcare system, and maybe it’s time to rethink how we think about it. Fastcompany [ http://bit.ly/1cTIMMk ] says “Defining the problem via design thinking requires the suspension of judgment in defining the problem statement. The right words are important. It’s not ‘design a chair’, it’s…’create a way to suspend a person’. Frame the problem in a way that invites creative solutions.”
I am fortunate to be able to see out-of-the-box thinking at ActionCue every day. A culture of empathy for what is going to improve the way the customer does her job is always at the top of the list. Any business – clinic and hospital included – can do this. Here’s a really fun video by Daylight Design, Inc. about how a team of design thinkers took on the very serious issue of childhood obesity. As you watch, be mindful of the process of thinking creatively about your specific issues and about who your priority is. Maybe there is a way to turn the story about long-standing problems into the moment that everything changed.
Remember learning about the Hawthorne Effect? It’s a phenomenon first described by Elton Mayo and Fritz Roethlisberger, published in the late 1930s, in which “subjects in behavioral studies change their performance in response to being observed.” (http://hbs.me/1sGFCRy) As the theory developed, this was seen as employee motivation and productivity being enhanced by feeling special as a result of direct supervision, social participation in the workplace, and a host of other ground-breaking ideas at the time. Although the Hawthorne Experiments have been criticized over the years for lacking scientific rigor, the ideas generated from this work became the foundation of employee-as-human thinking, and it’s hard to argue with that. You pay attention to people and they do better work. So far so good, right?
This month, a Canadian study was published that looked at the relationship of hand hygiene compliance to hospital staff awareness of being observed washing their hands. (https://www.hbs.edu/faculty/Pages/item.aspx?num=52445) Predictably, staff compliance increased 300% when they were aware of an auditor lurking nearby. This was labeled by the researchers as a result of the Hawthorne Effect. The troubling conclusion was that due to data being collected while staff are observed, the actual hand hygiene compliance rate is being inflated in publicly reported data. The implications of inflated rates or, specifically, worse hand hygiene compliance than what is being reported, disturbs on several levels including decision-making and policy-setting based on inaccurate data.
The important part of this for hospitals is how to get accurate data. If the Hawthorne Effect is the golden ticket responsible for improved performance but also the culprit behind inaccurate data, then we have some sorting out to do. Yes, we want to see 300% improvement across all our quality measures – but does that mean always standing over people watching them hang IVs, administer medications, and use appropriate sterile technique? Not likely. Back in Elton Mayo’s day when the work force was still finding a respectful work place, it appeared that attention to the employee, so sorely missing back then, could take the form of manager proximity to the employee performing his or her duties. This was construed as being engaged, and the employee felt singled out in a very positive way. These days, we expect our staff to be conscientious whether or not the QI Director is auditing performance. And, equally as important, we want staff to know they are respected and their contribution to the organization is valued.
I was on the phone with an ActionCue client today, an infection control nurse at a small hospital, and we were talking about how she collects hand hygiene compliance data. She said that she is going to have other manager/supervisory staff make ten observations a month of hand hygiene compliance in the course of their regular day on the floor. If she has even three helpers, that is 30 additional observations a month. More observations lead to more reliable data, and different people will be responsible which will decrease the auditor presence that seems to “Hawthorne” the data.
So try this: 1.) Get more people involved in quality improvement by sharing data rates with all staff, 2.) allow more people to be responsible for data collection to improve data volume and reliability, and 3.) rotate data collection to increase accountability –we’re all in this together! You will simultaneously let staff know you value the integral part they play and, I believe, get real first-person data collection that you can trust.