ICP: Find a champion for infection prevention
Innovative prevention possible in all settings
Having worked with a "physician champion" and greatly lowered infection rates by adopting an industrial process model, an infection control professional has joined the chorus that say infections are not an inevitable byproduct of medical care.
"You can have success in any hospital," said Cheryl Herbert, RN, director of infection prevention and control at Allegheny General Hospital in Pittsburgh. "I am totally convinced of that. You can pick an ICU, a general unit, anywhere in your facility where you can find some people with passion who want to help you make a change."
Herbert worked with Richard Shannon, MD, who spearheaded novel programs that led to dramatic reductions in infection rates at Allegheny before he took another position at the University of Pennsylvania in Philadelphia. Shannon showed that drastic reductions in central line blood stream infections were possible by adopting an industrial model based on production principles created by Toyota automobile manufacturers. The system uses intensive observations to detect variances from established practices and calls for root-cause analyses of all infections. A key component is that workers are empowered to implement counter-measures designed to eliminate the defects in the processes of central line placement and maintenance.
"Infection does not have to be the inevitable outcome of health care," Herbert said at a recent press conference highlighting her program. "We all learned about how the Toyota production model could be applied to health care. And really what it comes down to is that everyone involved in the care of our patients has the ability to stop processes, stop work if something is gong wrong and to feel empowered to speak out without any punitive action and let's talk about how we can fix things."
Though highly successful, the program is not for the faint of heart. "I don't want to try sugarcoat this; it was very difficult work," she said. "And it is hard to maintain this standard every single day. You know, we have issues in Pennsylvania. I have issues in my hospital. I am sure that you all do, too. Public reporting has been very challenging. But we need to do it. There should be nothing to hide. And it was hard to get everyone involved and convinced and up to speed on what needed to be done to move all of this forward."
However, the collaborative effort required under such programs yields benefits of its own, she added. "I have found and come to believe very firmly that if we reach out and let everyone into our world of infection prevention, it can be a very freeing experience," Herbert said. "I think we always have felt that the burden of infection prevention was on the ICPs. Many of us have little or no help, sort of a world onto our own out there doing some kind of mysterious work. We didn't get a lot of empathy from our co-workers because they never really understood what it was we did except to run around and tell people to wash their hands."
As a result infection prevention has become an isolating experience, as ICPs establish their turf and stay in their silos. "We need to demystify the work that we do; teach everyone," she said. "I am still as respected now, perhaps even more so because I reached out and allowed every single person that wants to understand our data and wants to understand what we do to be involved."
If possible, ICPs should find a champion within the hospital to promote the program and broaden collaborations. "Maybe it's a doctor, maybe it's the director of nursing, but try to find those people," she said. "That's the first step, because they're there. And once they understand that you want to work with them and you all have the same goals in mind, it does get a little bit easier."
Having worked with a "physician champion" and greatly lowered infection rates by adopting an industrial process model, an infection control professional has joined the chorus that say infections are not an inevitable byproduct of medical care.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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