Practice Management - Clean is as clean does

February 20, 2015
From the January/February 2015 issue of HealthCare Business News magazine

Expecting a single technology to reduce levels of body fluids would be the equivalent of a household placing a pan with half of Sunday’s leftover pot roast in a dishwasher and asking that dishwasher to miraculously digest the leftovers — roast, veggies and all — while also cleaning, sanitizing, and drying it.

When thinking about safety in a health care environment, we first think about clean. Clean surfaces, clean floors, clean linen, clean bodies, and clean hands. Clean can be as simple as free from visible soil. Clean gets rid of that spray of blood or that pint of vomit. The next step is where technologies like UV, ozone, hydrogen peroxide, and myriad antimicrobials can work on whatever microscopic contamination is left. We cannot sanitize, disinfect, or sterilize without first having clean. Products that claim to do both or all are simply not real.

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The “positive deviance” of clean
Health systems, hospitals, health care workers, executives, researchers, and manufacturers need to work collectively together. Diverse working groups with cross-functional backgrounds that are focused on solutions for a cleaner, safer health care environment is now a phenomenon growing in public health and health care called “positive deviance.” Positive deviance is an asset-based, problem-solving, and community-driven approach that enables a community to discover uncommon successful behaviors and strategies, and develop a plan of action to promote their adoption by all.

The practice has been used in infection prevention in innovative ways, using feedback techniques where all groups within the health care facility participate. These groups include those without traditional clinical roles. For instance, in one urban hospital, it was the clergy that identified a possible way to break the chain of transmission when visiting patients from one room to the next, by wrapping their holy book in between visits. In the forward to the book, “The Power of Positive Deviance” Dr. Atul Gawande offers the following:

Along the way, you will sometimes feel worn down, your cynicism taking over. But resist. Look for those in your community who are making health care better, safer, and less costly. Pay attention to them. Learn how they do it. And join with them.

Ultimately, clean is as clean does.

About the author: Amber Hogan Mitchell, DrPH, MPH, CPHleads Vestagen Technical Textiles’ regulatory affairs, scientific, and educational initiatives. She specializes in regulatory and policy issues related to safe, quality healthcare. She was the OSHA National Bloodborne Pathogens Coordinator and has several Secretary of Labor Excellence awards.

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