tag:blogger.com,1999:blog-32053362.post1292270864682737850..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: Good timingPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger11125tag:blogger.com,1999:blog-32053362.post-65386797562427509382009-04-20T00:45:00.000-04:002009-04-20T00:45:00.000-04:00This backs your comments re washing 2-3 times duri...This backs your comments re washing 2-3 times during a visit<br />Official report of the transfer of MRSA bacteria & germs etc in hospitals(curtains, bedrails, computer screens) have a look at the Report by Sydney University Microbiology Dept on a major Sydney Hospital.<br />http://www.deconshield.com/pages/why-decontaminate<br />Major Sydney Hospital Report on Transmitting MRSA on Hospital Surfaces by Sydney University Microbiology Department:Molly23https://www.blogger.com/profile/04119813307781455452noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-83204388740791050092009-04-19T12:28:00.000-04:002009-04-19T12:28:00.000-04:00Nope, but my yard REALLY needs work . . .Nope, but my yard REALLY needs work . . .Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-47271128465279961442009-04-19T12:25:00.000-04:002009-04-19T12:25:00.000-04:00Yep, that's my side crusade while retired and now ...Yep, that's my side crusade while retired and now pursuing other interests - provide data and opinions on my former career field! Got any more 200 page documents??!! (:<br /><br />nlAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-65287133940926116822009-04-19T11:35:00.000-04:002009-04-19T11:35:00.000-04:00Thanks. It's great to have an involved reader who...Thanks. It's great to have an involved reader who is both OCD and retired -- has both inclination and time!<br /><br />:))Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-78425939999496523292009-04-19T10:26:00.000-04:002009-04-19T10:26:00.000-04:00OK, my OCD made me look it up - text box 9-3 on p....OK, my OCD made me look it up - text box 9-3 on p. 115. In a hospital your size (as oppposed to 211 beds), a larger observation team would be necessary.<br /><br />nonlocalAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-56445848352245501542009-04-19T10:21:00.000-04:002009-04-19T10:21:00.000-04:00I can't answer your question since I didn't read t...I can't answer your question since I didn't read the whole thing, but the table of contents indicates that the document spends a great deal of time on methods of data-gathering: observation and otherwise. I assume that the hospital in question (whose name escapes me, but it's somewhere around page 107-117) used one of the methods of observation discussed in the other chapters.<br /><br />The document also mentions that physicians who were with a peer or superior who did not wash their hands during a patient encounter, were less likely to wash their hands themselves. This has obvious implications in an academic center with medica students, interns and residents.<br /><br />nonlocalAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-9408979306041543492009-04-19T09:02:00.000-04:002009-04-19T09:02:00.000-04:00This also seems to require some kind of observer c...This also seems to require some kind of observer corps. Does it explain how that is accomplished? Is everyone else deputized?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-74077397981254811472009-04-19T09:00:00.000-04:002009-04-19T09:00:00.000-04:00One of the benefits of being retired is no longer ...One of the benefits of being retired is no longer having to read 200 page documents ((:), but I did skim p. 2, on "observed risk factors for poor adherence....", and Chapter 9, looking for information applying to physicians. <br />The first listed factor in the poor adherence chart is....physician status (as opposed to nurse.) Also among the top 10 is male gender.<br />In chapter 9, one hospital's system for dealing with poor physician adherence is presented:<br /><br />"Non-adherent physicians were observed without initial<br />verbal intervention and were allowed three observations of<br />non-adherence every six months. Physicians reaching the third<br />observed episode of non-adherence were given a series of<br />letters: the first to the physician directly; the second to the<br />physician and to his or her department chair; and the third to<br />the physician, the department chair, and the credentials<br />committee. Further action with regard to any continued<br />physician non-adherence was the responsibility of the<br />credentials or executive committee, according to the medical<br />staff by-laws."<br /><br /> The time frame seems somewhat generous, but this suggests some interesting options, such as inserting into the bylaws a mandate for complying with hospital policies (or enforcing it if already present) to achieve re-credentialing. <br />Of course, this will only work if physician leadership is willing to actually follow the process all the way to its logical conclusion.<br /><br />nonlocal MDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-87073161758165838102009-04-17T12:03:00.000-04:002009-04-17T12:03:00.000-04:00On a side note, various departments are banning us...On a side note, various departments are banning use of "department fleeces" and "cloth OR hats" because they are not laundered by the hospital and are at increased risk of infection -- our white coats, however, are not dry cleaned by the hospital (the only hospital I rotate through that does not provide this service) -- and yet white coats have yet to be banned. Should we also ban white coats, or start providing laundering services for physicians/medical staff's white coats?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-26380041330269336972009-04-16T13:16:00.000-04:002009-04-16T13:16:00.000-04:00Hi Paul,
I started to draft a response to your po...Hi Paul,<br /><br />I started to draft a response to your post on Monday "Looking for your help," but got waylaid until today. I thought I'd share it here since the discussion has moved forward, and TJC guidance reinforces what I was thinking. <br /><br />I think your inclination to dig deeper into the meaning behind (what on the surface looks like) non-compliance is correct. My brother is an engineer/project manager with an international company that walks, talks, speaks, thinks, and acts "safety." Their culture is far more safety-conscious than you and I will likely see healthcare become, given the number of years we can expect to remain "in the game" (or "here on earth.") :)<br /><br />Here's a story about safety my brother passed along to me: <br />A group of die-hard, fully enculturated professionals (with responsibility for on-the-job safety) attended a safety conference where they were subjected to a mini-study about behavior. An extension cord--absent any fall-mitigating protection--had been deliberately strung across a walkway in the room that morning. The agenda moved forward, and breaks were taken. Around mid-day, the group was asked to perform a safety analysis of their conference room, identifying any egregious issues. The potential for fall posed by the cord was readily identified as a high risk by the majority of participants. Nothing further was said or done at that point. Following the lunch break, it was noted that a participant had re-routed the cord so that the fall potential was mitigated.<br /><br />The take-away lesson: Even in safety-oriented cultures, knowledge does not translate into action unless safety is a visible priority that gets space on important agendas.<br /><br />Thanks for helping keep safety visible on the "agenda" you host here. I blog about reliability in healthcare at http://florencedotcom.blogspot.com/and hope you'll consider adding my site to your blogroll.<br /><br />Best,<br />BarbaraBarbara Olson, MS, RN, FISMPhttps://www.blogger.com/profile/17580039684980409341noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-76103466459078069932009-04-15T08:16:00.000-04:002009-04-15T08:16:00.000-04:00Hi Paul: I got a little chuckle out of #4 above. ...Hi Paul: I got a little chuckle out of #4 above. Those wily bacteria don't care if the compliance rate is 99%, as long as one of them survives in the right place at the right time. Infection control is one place where being perfectionistic is a really good thing. I am looking forward to participating in the forums we will be having.catsandmusicnoreply@blogger.com