Friday, October 2, 2015

Hold out clean hands

Published in VC's Notes on October 02, 2015

Hold Out Your (Clean) Hands

Those of us who work in health care take pride in it.

And we should.

It's not unlike the military.   We have our own uniforms.  Our own language.  Our own rites and rituals.  Our own symbols and badges of membership and achievement.

Those behaviors are actually typical of teams, and particularly elite teams.

HandsI want to start another tradition that is going to be a special sign of membership on the elite University of Mississippi Medical Center team.  It goes like this:  Take your hands, wash them thoroughly or foam them before encountering a patient, and then hold them out in front of you with pride to show your patient.  Do it again as you leave the patient.

That's the sign that you are a member of the UMMC Clean Hands Team.  

Folks, I'm completely serious.

During a recent month, we conducted discreet observations of our staff interacting with patients - 3,741 observations in all.  Staff members appropriately washed their hands only about half of the time.  That means the other half of the time we were spreading bacteria, some of it potentially lethal, around our patients' rooms and even on our patients. 

We all know this is unacceptable. 

Studies suggest that most hospital-acquired infections are the result of poor hand hygiene.  UMMC had approximately 300 last year.  

Those infections often result in added cost to the Medical Center, in the form of unreimbursed care, financial penalties from Medicare or the opportunity cost of not having a bed available for the next patient.  That's money that could have been used for other pressing needs. 

Vastly more important, poor hand hygiene exposes our patients to unnecessary risk, and violates our own ethical promise to "do no harm." 

I know, I know - hand washing can be a hassle.  You're busy.  In an emergency, there's no time.  The chief resident doesn't do it.  The foam dispenser is way over there.

But those excuses - if you'll pardon the expression - just won't wash.  

Do it anyway.  Make it a priority.  That's what elite teams do.  It's a measure of how much they care.

Our clinical leadership has set a goal to achieve an 80 percent compliance rate in hand hygiene.  I have no doubt we will get there.  But I won't be satisfied until we're a few decimal points below 100 percent.  And neither should you.

Many of you are already there.  Thank you.  I'm empowering you to gently and constructively invite those around you to join the club.  Because again, that's what good team members do for their buddies.

I'm going to return to this topic a year from now.  When I do, I want UMMC to be known far and wide as the place that cracked the code on hand hygiene.  I want clinical leaders from other academic medical centers to visit Jackson to learn how we achieved such startling results.  And I want them to watch in wonder as our physicians, our clinical staff, our housekeeping staff engage every patient, every time with their clean hands extended in greeting.

That will be our team's badge of honor, our not-so-secret sign that says to every patient:  "This is how much I care about you."

And becoming an elite health-care team will take us one giant step closer to A Healthier Mississippi.



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