There are always going to be new microorganisms emerging , but a consistent approach to hand hygiene , PPE use , screening , cleaning and disinfection of high-touch surfaces and other practices can help protect against them .”
— Jim Gauthier , MLT , CIC
of the departments . It was noticed by institutional leadership , who provide us with some resources to complete a pilot study . We tested processes together , with the final decision to be made by environmental services personnel . We needed their buy-in to ensure they felt comfortable with the process we would select and would believe in the results . We trialed ATP and fluorescent marking commercial products that were unsatisfactory . So , we created an interview tool , an audit survey , with the collaboration of senior infection control and environmental services personnel , with 80 percent of EVS personnel behind the final choice of method . They really liked the fluorescent marking , but the most important thing about the finding was the unexpected outcome , which was the growth in the relationship between infection control and EVS .”
Despite the method used to monitor and audit , Bruce emphasized that the biggest challenge was how to deliver feedback to frontline workers .
“ It can be controversial ,” Bruce acknowledged . “ Dr . Brennan , considered to be the expert in the field of giving feedback , says that in general , we do not provide feedback very well as a general population , not specific to the healthcare segment . She has said we ’ re not giving feedback in a brain-friendly way and that we probably fall into two camps . We ’ re either in the camp where we don ’ t really like giving feedback , so we take the sandwich approach where we sandwich bad feedback between compliments . So , the person receiving the feedback might not actually receive the real point of the feedback , which is the need for behavior change . The other camp is where we provide feedback very directly , pointing out what someone did very poorly and then that puts the individual in a defensive mode . Dr . Brennan has said that we need to focus on how we ’ re giving feedback , making sure it ’ s friendly , because even if you ’ re an effective feedback provider , the recipient of the feedback can go into a sort of fight-or-flight mode . I think that ’ s very important . She reminds us that we don ’ t have to fall into one of those two camps . She conducted feedback-related studies in her lab and created a four-step formula for providing feedback .”
Bruce continued , “ The first step goes something like this . ‘ Hey , Natalie , can I talk to you about XYZ ?’ That sets the tone for further discussion and subtly decreases the fight-or-flight response because the recipient is in a position to say yes or no and feels somewhat in control . The next thing that effective feedback-givers do is put a data point together , so the conversation is concrete . So , something like , ‘ Natalie , you were going to send me that e-mail at 9 a . m .’ There are no ‘ blurred words ’ as Dr . Brennan puts it , so that it ’ s not confusing . The email was not sent when it was supposed to ; there ’ s nothing subjective in that statement . The third step is to include an impact statement . ‘ So , Natalie , you didn ’ t send the e-mail at 9 a . m . I was going to present the data from your team ’ s audit to the board , but I couldn ’ t because you didn ’ t provide it .’ All of a sudden , I see the impact , I know the outcome of me not sending the email when it was expected of me . Finally , the fourth step is wrap it with a question , where the individual receiving feedback is asked if there is anything they would like to add . That way , the individual has buy-in again , because I am being asked to provide feedback on my suboptimal performance .”
Bruce added , “ What ’ s interesting is that for even those people who are good at giving feedback , that feedback is not valuable . Recent literature in the human resources sector is indicating that feedback is not all that ’ s cut out to be . Even for those people who do a great job in providing feedback , the process is still about looking back to the past and what went wrong . Experts now suggest that we need to employ what is being called ‘ feedforward ’ instead of ‘ feedback ,’ focusing on the future . So , what the supervisor does is ask the employee ‘ What went well for you ?’ and suddenly it becomes a discussion about what the employee thinks succeeded and how to further get to a goal . Then the supervisor asks , ‘ What are the gaps or barriers to get there ? What do you need to achieve the goal ?’ It ’ s a positive way to set goals instead of focusing on the past ; the past is the past , there ’ s nothing you can do about that . Instead , start focusing on the future and how to move forward . It can be challenging , as so many of us are hardwired to review the past and what went wrong , and that can impact relationships .”
Bruce continued , “ If we want to change behavior , meaning we want environmental services to be doing what needs to be done to keep patients safe , we must identify opportunities for improvement among EVS personnel , talking about achievements and challenges , and how we will design ways to address future issues . This is going to require a mindset change , obviously , representing a paradigm shift in how we approach feedback directed at low performers that are enjoying risky behavior . One of the things we need to ask ourselves for our EVS teams is , ‘ Are we giving feedback in a way that is logical , inspiring , and meaningful to them . I think it ’ s important to advocate for our EVS team , letting them know they are critical to patient safety in our institution . We know that getting feedback from a supervisor that you know is proactive in your performance and passionate about it , you will give your all for . There ’ s no faster way to lose engagement with someone than to speak to or be spoken to in a way that you do not feel that you ’ re heard or respected . Let ’ s try to provide feedback that inspires in a brain-friendly way .”
• • •
In the final presentation of the Cleaning & Disinfection Symposium at 2023 IPAC Canada , infection prevention expert and educator Jim Gauthier , MLT , CIC , addressed the concept of horizontal infection prevention strategies .
To review this concept , Wenzel and Edmond ( 2010 ) explain that “ In general two epidemiological
22 july 2023 • www . healthcarehygienemagazine . com