Training and empowerment are the keys to providing quality care

August 11, 2017
By Thom Wellington

Health care associated infections (HAIs) are drawing increasing attention from patients, insurers, government and regulatory agencies.

Everyone must understand their role in improving outcomes. Education is essential for infection control since most HAIs are considered preventable. You would not get on an airplane knowing the pilot had no training. It’s not just pilots who require continual training. Most of us who are licensed to perform certain tasks are required to take annual training to maintain licenses. Training plays a key role in keeping patients safe and reducing preventables.



A breach in infection control practices facilitates transmission of infection from patients to health care workers, fellow patients, the surrounding environment and others. It is important for all health care workers to adhere to infection control guidelines. It is also imperative for health care administrators to ensure the infection control program is implemented. Training and education are necessary to assure all health care workers are equipped with the necessary knowledge.

While in hospitals, I often ask technicians how they were trained to perform their required tasks. Unfortunately, most respond that either co-workers or the person leaving the position provided the training. Standardized training on specific equipment or cleaning techniques is scattered, and retraining is often never provided. This educational weakness has led to serious injury and death for patients. Almost monthly we see a case of multiple infections or deaths created by an improper practice, something that could have been prevented with continual training and education.

Captain D. Michael Abrashoff’s book, “It’s Your Ship,” is a perfect read for hospital administrators who truly want to change course and improve outcomes. When Abrashoff took the helm of the USS Benfold, it was loaded with the most advanced technology, but a crew that did not fully understand the mission, nor were they as productive as other Navy crews. Actually, it was the worst ship in the Navy. Instead of scrutinizing the crew with the presumption they would screw up, Abrashoff took a totally different approach. While analyzing every process on the ship he asked, “is there a better way to do what you do?” The approach paid off when he actually took their advice and changed a practice. Soon, more suggestions came in, and new approaches and protocols were established. The crew felt like they were part of the management process and were eager to learn more skills.



When an administrator decides to demonstrate that crew input is important and actually incorporates their suggestions, attitudes change. After months of demonstrating change created by the crew, things changed even faster. The sentiment was now obvious. The crew thought the captain cared more about performance and about them than about his next promotion. Aboard ship you have sailors from every type of background and education, not too different than everyone working in a hospital. Making sure everyone feels part of the team and has a voice is the key to pushing success to excellence. Abrashoff started duplicate training to ensure at least two people always knew each job task and received continual training. Part of being a team is filling in when needed with no loss of skill set.

The Cleveland Clinic, like other prominent health care systems, embraces change to optimize patient outcome. The Cleveland Clinic’s Toby Cosgrove, M.D. understands it is not about him. It’s about empowering an entire team to achieve superior outcomes. This is evident even when boarding any of the numerous shuttles between buildings on the main Cleveland campus. Shuttle drivers are compassionate, educated on each building and go out of their way to reduce stress. The attitude quickly becomes contagious as patients and family members familiar with the campus are eager to help others get to their destination. Customer focused training does not pick and choose at the Cleveland Clinic. Everyone is trained and everyone knows the importance of empathy.

Cosgrove has created a culture that allows everyone to explore new ideas with the patient as the focus. The team at ICU had a new idea for reducing health care associated infections (HAIs) caused by contractors and maintenance technicians that was overlooked at most hospitals. Spending time educating all the outside vendors that perform work in hospitals was an impossible task to corral. Pushing the education to the cloud and making it available from any smart device 24/7 with testing to verify learning just made sense. While other health care systems struggled with trying something new, Ronald Lawson, vice president of construction services, jumped at the alternative training delivery that benefited patient outcomes and aided in reducing HAIs.

“It’s all about preventing mistakes that injure a patient,” according to Lawson.

Unlike other hospitals that recognized the value, but were fearful of pulling the trigger on making a decision, Lawson quickly evaluated the program with peers and got started.

Standardized training is necessary to achieve better outcomes. Combining education and empowering employees focused on a mission is when excellence happens.

About the author: Thom Wellington is the CEO and a stockholder in Infection Control University.