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David Daniel
David Daniel

Zero tolerance

Take steps to implement infection control

By David Daniel
Posted: January 3, 2011 - 12:01 am ET

No patient should have to endure what Karen Morrow has endured. In a Las Vegas ambulatory surgical center for a routine colonoscopy, Morrow contracted hepatitis C because the staff committed a cardinal medical sin. They reused syringes and single-dose vials of anesthetic. As a result, Morrow suffered through a year of painful and expensive treatment. She lost her hair, her job and the ability to manage her life independently. She even needed help with grocery shopping and caring for her dogs.

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Karen Morrow suffered needlessly because infection control was not taken seriously.

To my peers, how can you not get directly involved in your facility's infection control program? Just one bad policy, poor procedure, unsupervised practitioner or uncaring staff member may mar a patient's life forever.

Selfishly speaking, if your outpatient center or hospital's name appears in the newspapers for unnecessarily infecting one of your patients, or if you're sued for malpractice and you lose, what is the true cost to your organization? Can you afford the financial penalties of not complying with Medicare's infection control guidelines?

The Lakeland (Fla.) Surgical & Diagnostic Center, outside Tampa, treated 19,000 patients last year in our two facilities, which have a total of six operating rooms and five procedure rooms. We deal with multiple specialties but were never ground zero for infections. Three years ago, we drew a line in the sand and said one infection was too many and initiated steps to eradicate them completely from our facilities. We've reduced infections by four-fold over three years, and had only two last year. But that's two too many. We're targeting zero infections because that's what's best for our patients.

Getting to zero is hard. We created a new, comprehensive infection control and prevention program that I oversee personally. It includes five steps:

n Drive a company-wide culture shift. Starting at the top, encourage physicians and staff to embrace infection control as part of the company's mission. Make it part of every interaction and procedure until it becomes second nature to all employees. We rewarded good behavior and protocol compliance on the spot, in front of everyone, so everyone knew we were serious and understood our expectations.

  • Hold people accountable. Employing the old tried-and-true management tool of making people accountable for following good infection control policies and practices still yields results. CEOs should insist on inspections and taking corrective action to ensure full compliance.

  • Use all available resources. Make the best of situations you encounter and use all the knowledge, expertise, equipment and products available today. Hand washing and strategically placed disinfectants will save lives and lower the risk of infection. Do it.

  • Pay attention to detail and be consistent. Keep up the surveillance, training, testing, inspecting, cleaning, sterilizing, washing, monitoring, follow-up, meetings, documentation and certifications. Just one slip-up could have a negative impact.

  • Always do the right thing. Lead by example: If you see something amiss in your facility, no matter what it is, take the time to correct it.

No CEO can do it all, nor should one try, so I appointed infection control officers at both LSDC facilities and approved funding for extensive infection prevention staff training. To stay informed about evidence-based best practices, staff members attended courses by the Association for Professionals in Infection Control and Epidemiology, as well as offerings from the Association of periOperative Registered Nurses and the Society of Gastroenterology Nurses and Associates.

With healthcare reform's additional focus on quality, including the reduction of infections, CEOs will need to pay greater attention to their infection rates. But none of those factors are more compelling then Karen Morrow's experience. Her ordeal should make every CEO realize that they have a moral responsibility to eliminate infections.

David Daniel is CEO of Lakeland (Fla.) Surgical & Diagnostic Center and recently won the second annual Healthcare Administrator Award from the Association for Professionals in Infection Control and Epidemiology.

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