Hospital-Acquired Infections

Continuing from a friend's experience that I blogged about last September 1st, now consider General Electric Healthcare's response to the hospital-acquired spinal infection of Jack Welch, retired GE Chairman and CEO. Last month their Smart Patient Room technology began observing hospital room hand-washing practices. Sensors detect and differentiate patients, visitors, hospital staff, nurses and doctors. Hospital workers who do not wash their hands before and after patient contact are entered into a Medical Errors Reporting System. GE's press release states:

"With the integration of this new technology into existing hospital rooms, the Smart Patient Room solution is designed to provide clinicians with real-time monitoring for patient risk and the ability to intervene via gentle notification. The system is designed to track protocol adherence such as proper hand hygiene compliance before and after interacting with a patient, periodic clinical rounding, and monitor for increased risk of patient fall."

Maggie Mahar addresses this new development in her blog:

"As a health care reformer, I find the whole idea of setting up cameras and sensors to monitor doctors and nurses terrible depressing.  If we have to spy on doctors and nurses in order to force them to wash their hands, we might as well throw in the towel. Such surveillance suggests that our health care system is beyond salvation. These people are not convicted felons in a prison block—they are medical professionals.  The vast majority are genuinely concerned about patients and work hard to do the right thing."

Interestingly enough, GE Healthcare also supports the non-profit Center for Transforming Health Care, whose Joint Commission developed the Targeted Solutions Tool with eight voluntarily participating hospitals, raising hand hygiene compliance from a 48% baseline to 82% sustained for eight months. A non-technological, relatively inexpensive teamwork approach is indeed possible. In another study, calculating from hand-hygiene product consumption, McGuckin, et al. found a baseline rate of 26% in intensive care units and 36% outside the ICU. Feedback to the personnel involved increased these rates to 37% and 51%, respectively, still a poor performance.

Considering a friend's experience of zero hand-washing compliance, the impact on patients' quality of life due to poor hospital hygiene, and the billions of health care dollars wasted annually due to medical error, I am in favor of GE's approach to behavior modification.

What approach do you suggest?