Monday, October 26, 2009

Not all fun and games, but they help

Following up on one of the recommendations in the item below, you may recall that I have written before about the use of games and other light-hearted events to promote better hand hygiene. That, plus a lot of hard work, has resulted in general improvement in the hospital.

A key part of the program, consistent with our transparent approach to process improvement, is that we share data about every floor with every floor, so there is an overall awareness of how we are doing. Our measurements are based on a combination of direct observation and keeping track of quantities of CalStat used on each floor relative to the number of patients on that floor. We are now at the point, as noted below, of increasing our goal.

Here's the form of the message that goes out from Linda M. Baldini, RN, CIC, CPHQ, Infection Control\Hospital Epidemiology, to each floor, all of the Chiefs of Service, Division Chiefs, and many other people at the end of each observation period:

The latest hand hygiene reports for all units are now available. Reports are available on the online Infection Control manual. The link may be found on the new portal.

The most recent report is for Period #25 (7/4/09 – 8/28/09) and is generated using data on usage (counting empty soap and CalStat containers) and census (patient days) for each unit. These data closely mirrors that obtained by direct observation of hand hygiene performance of health care workers during the same period. Note that L&D is considered an ICU in this report due to similar nurse:patient ratios.

The reports available include:
ICU hand hygiene reports (all units on one graph) Non-ICU hand hygiene reports (all units on one graph) Average ICU and non-ICU hand hygiene performance over time Individual graphs for each unit over time

Congratulations to L&D, CVICU, MICU 7, 7 Feldberg, 6 Feldberg, 5 Feldberg, 5 Stoneman, Farr 10 for reaching goal this period of ≥80%!

An email reminder will be sent to you after each intervention period, approximately every 9-10 weeks. Please share these data and information with your unit-based staff at all levels and physicians. Feedback of data has been shown to help improve performance.

You can see the data, too, on our corporate website. As I have often mentioned, we believe that public presentation of our performance data stimulates internal improvement by helping to hold ourselves accountable to the standard of performance for which we stand.

But back to the game idea, here's the latest campaign, announced last week:

To: BIDMC Community

From: Ken Sands, MD, MPH, Senior Vice President of Silverman Institute for Health Care Quality and Safety

Sharon B. Wright, MD, MPH, Director, Infection Control/ Hospital Epidemiology

Subject: Raising the Bar on Hand Hygiene

Starting with the new observation period that begins Oct. 24, BIDMC will increase its hand hygiene compliance goal from 80 to 90 percent across the medical center. To help roll-out this new initiative we will introduce a fun new incentive program to help inpatient unit staff improve their hand hygiene compliance.

BIDMC Bowl-O-Rama (Knock Down The Germs) will use a bowling-themed scoring grid to communicate unit performance in each measurement period. Those units meeting the new goal will receive rewards such as bowling shaped cookies and coffee to winning units at the halfway mark (April, 2010), and a big party with raffles during Infection Prevention Week in October 2010.

Our grand prize will be a Wii game system, including the sports/bowling program, as well as other bowling-themed prizes, gift certificates to area bowling alleys, custom made bowling shirts (for select Hand Hygiene advocate champions), and movies such as and “The Big Lebowski.” Unit-based bowling trophies will also make the rounds to highlight and reward compliance.

To learn more about this new initiative, please join us at the Infection Prevention Week informational fairs in the east and west campus cafeterias on Oct. 21 and 22, from noon to 1:30 p.m. The fairs include free prizes and Wii bowling.


Anonymous said...

A key strength of this work is the sharing of data across the institution. Too frequently in Boston's siloed medical system, departments/floors/service lines report internally to health care quality and do not take advantage of the power of transparency and competition to change high risk behaviors and work flow. The best dashboard that I have seen has a number of metrics (including hand hygiene) shared horizontally and vertically from front-line staff all the way to the board on a weekly basis. Some directors may not read this posting as frequently, but the rest of the institution knows that they care about the numbers and are in the same loop.

Bob said...

What a fun idea. I'm going to suggest implementing similar at our offices. Really enjoying the information. I found your blog after David M Scott spoke to us about the New Rules for Marketing and PR.

I'm happy to see that you maintain this medium and have embraced 'social networking'. I'd like to ask a few questions about your process, successes and drawbacks if you have a few moments, or wouldn't mind an email?


Bob (