I think they are reading this . . .

While I know that lots of you out there from all over the world are reading this blog, I really don't know how many people inside BIDMC are. But, every now and then, I get word that someone is and has used what I have said to help motivate their own folks. As I have noted below, in an academic medical center, you are highly dependent on individual motivation to make improvements.

Here's the latest, from one of the leaders of the Emergency Department to every person working there:

From: Tracy,Jason A (BIDMC - Emergency Medicine)
Sent: Sunday, April 15, 2007 1:53 PM
To: Emergency Attendings; Emergency Residents; Emergency Techs; Emergency Nurses; Emergency Registration; Emergency UCO
Subject: Our CEO & "Dirty" tickets

Please note our CEO’s concern about hand washing & infection control at BIDMC: http://runningahospital.blogspot.com/2007/04/i-want-to-be-proud-but-i-am-not.html

Contaminating a vulnerable patient with a methicillin-resistant staph can result in a disastrous outcome. Hand washing is needed to keep our ED patients safe.

ED hand washing initiatives include:
- Improved signage & education – signs are posted throughout the ED (thanks Sue) and an educational campaign has started
- Peer-review and feedback – please help educate your peers, off-service rotators, students, support staff, etc.
- Spot checks & mystery observers (by ED team members and ID staff) – these “secret” checks are for statistics and feedback
- Cal-stat usage checks – the hospital tracks how much Cal-stat we use and analyzes usage based on patient encounter models
- “Dirty” tickets – these hand washing violations (tickets) will be given to violators to be signed by their supervisor

Yes, it is very difficult to wash/Cal-stat so much. Yes, it takes extra time. Yes, there are other safety issues to focus on. Yes, it’s fast-paced in the ED.

However, for all the reasons stated in our CEO’s blog, it’s not optional and we must do better.

Please send me any other ideas to improve compliance (short of a Cal-stat dispensing bedside turnstile) and/or interest in helping with this initiative.