Infection control corner: 'I did not see that coming’

September 08, 2016
By Thom Wellington

We have all uttered the words, “I did not see that coming,” a phrase that is often tossed around lightheartedly, but even more so when something earthshaking happens in our lives. We try to plan for all types of life-changing events, but inevitably something will show up with a powerful impact that we just were not expecting, or that we are not in control over. Whether it is a divorce, a financial crash or getting fired at work, the unexpected can turn our world upside down. From that point forward, it is up to the individual as to what they will do next, whether that is continuing on with the day-to-day routine, or backtracking to try and fix it. Often enough, there aren’t second chances when the damage is already done.

The same can be said about a health care-associated infection (HAI). A patient makes a trip to the hospital for a routine procedure and the next thing you know, a life-changing infection occurs. All of us enter the hospital thinking we will be in excellent hands with our doctor and anyone else we meet along the way. According to statistics, it is true that most patients leave the facility in good condition and experience a positive event. We applaud these outcomes and hope that everyone has a great experience. However, statistics also point to negative outcomes, with 75,000 deaths a year attributed to HAIs. This means 205 people die each day from something they did not see coming, something that could have been prevented.

During a recent luncheon meeting with Ken Cates, a principal with Northstar Management and a board member of Federal Guidelines Institute (FGI), we had an interesting conversation about HAIs and how health care institutions need to act more like industry. Cates stated, “You understand the news coverage an airplane crash gets, the story continues for days. Interesting enough, an average airplane crash is about the same number of people that die per day in hospitals from HAIs and it doesn’t get near the news coverage.” Ken has been a strong advocate for training to educate everyone who enters a medical facility.

A mandatory safety, or specialized custom training, meeting is held by 90 percent of my corporate clients. For example, one large aircraft manufacturer’s training focuses on foreign object debris and how it is not tolerated. Leaving a tool or anything that could find its way into an aircraft part can spell disaster. The same is true at other manufacturing facilities, and workers are quickly escorted out of the building for not following rules and protocols. Unfortunately, health care institutions seldom hold mandatory safety meetings because everyone is too busy. Most incoming maintenance and construction workers are more interested in completing their task and have no idea of the proper protocols to keep everyone in the hospital safe.

To mitigate the risk of HAIs and legal costs, everyone employed and contracted by the health care system needs to be trained and certified in how their work can cause an infection. Whether the contracted infection is minor or life-threatening, the patient is still suffering and it is the hospital’s responsibility to keep patients safe and healthy. HAIs are recorded against each facility and can be accessed by the public. Keeping these numbers low is directly connected to the health care organization’s bottom line.

HAI litigation is a trend that should be on every hospital’s radar, especially since the frequency of hospital professional liability claims is increasing. According to a new study released by Aon Corporation, in conjunction with the American Society for Healthcare Risk Management, HAI claims are on the rise and are expected to increase annually.

The Aon study also found that one out of every four claims and nearly a quarter of hospital professional liability costs are associated with HAIs. As much as patients don’t see infections coming, hospitals are not recognizing that juries are starting to notice the trend, too. A jury recently awarded $13.5 million after a 40-year-old woman died of flesh-eating bacteria that she contracted during chemotherapy treatment. She did not expect to contract the bacteria and the hospital did not expect to be blamed for the spread of the bacteria.

To have a legally defensible protocol, hospitals must follow best practices, provide training to all staff and document that all protocols are being followed. This requires constant vigilance at all levels within the hospital. Hospitals develop their standard of care policy and must follow it because most health care-related lawsuits are not about the quality of care, but rather if employees are following regulatory guidelines.

Health care providers need to operate like well-run corporations. Protocols are established and followed by everyone. Training is highly recommended throughout all areas of the health care system to prevent patients and the facility’s employees from saying, “I didn’t see that coming!”

About the author: Thom Wellington is the CEO and a stockholder in Infection Control University, a company that provides staff training programs and control processes for infectious microorganisms in hospitals, clinics, long-term care facilities and other health care-related institutions.