and resolution issues to a successful conclusion , and hopefully put into future processes of the lessons learned . Let ’ s then not miss the biggest learning opportunity of all . Teamwork among the silo partners resulted in a positive patient-care solution . Why would or should the silos be maintained as status quo ?
A few answers would be “ We have always done it that way ” or “ I don ’ t want to change the process as it would be too hard ,” or “ I don ’ t like change .” The best way may be to start with the concept of a patient care multi-disciplinary team ( PC-MDT ) taking full responsibility for the entire scope of processes on a patient-focused basis . Here are some suggestions on membership of the PC-MDT :
● Infection Prevention & Control
● Environmental Services
● Microbiology and / or Laboratory
● Food Services
● Facilities Management
● Quality & Risk Management
● Nursing ( inpatient and outpatient )
● Administration
● Medical Device Reprocessing
● Infectious Disease Physicians / Epidemiologists
● Occupational Health & Safety
● Other stakeholders as required
Let ’ s also look at some of the initial tasks the PC- MDT can address in the short and long term :
● EVS is on the front lines of defense of HAIs and should be recognized for their heroic efforts with addition budget support for training and education
● HAI statistics ( facility , community , regional , national , etc .)
● IP & C staff attend clinical rounds
● Policies and procedures blended for an integrated approach
● Key performance indicators of success
● IP & C also focuses on an ‘ interventional ’ focus via a learning and problem-solving approach
● Observational auditing ( visual , marker , ATP , microbial culture ) including when who , how , cost , etc . and use the outcome in trending analysis , celebrating success and learning
● Organizational audits of departments or significant multi-faceted processes
● Specialized audits targeting potential sources of transmission ( sinks and drains )
● Chemical products ( manufacturer ’ s use requirements , safety , fit for the desired outcome , PPE use , etc .)
● Terminal , shared equipment and specialized cleaning
● Engineered infection prevention solutions such as ultraviolet light , ozonated water hygiene sinks , self-sanitizing surfaces like copper alloys
● Patient , visitor , physician , and staff surveys
● Building trust and success , not fault or punitive measures
● Target typically higher rates of common HAIs ( VRE , C . diff , MRSA , CPO ), and be on the outlook for fungal infections ( Candida auris , Aspergillosis ) and more impacts of SARS-CoV-2 variants
● Collaborate with local healthcare facilities on regional learning and cooperation
● Attending professional conferences with a cross representation of attendance
● Seek out local , regional , national , and international standards relevant to the facility ’ s needs .
● Recommendations to administration on operational changes and capital equipment or facility changes that have a positive impact on patient care ( Tip : while the upfront costs are very important , the real issue is what a proposed change can do to reduce HAIs , noted as a return on patient-care investment and a strong perspective that HAIs cause illness and death ) and financial issues for the facility
● Communication strategy to healthcare stakeholders
● Use science- and evidence-based decision-making
● Randomized clinical trials in environmental assessments do not do well in some multi-factorial HAI-related issues , but rather a practical approach of quantitative risk management assessment ( QMRA ) which has its roots in food services risk management and safety . This is about assessing the risk of transmission and developing changes to lessen the risk .
Did this whole discussion not start about who is responsible for safety ? We are all responsible for HAIs and should dedicate our resources and trust in a PC-MDT to lead the way to safer environment for patients , staff , physicians , and visitors . Remember , the word “ team ” has four letters that can spelled also as mate ; thus , we are all teammates .
Richard Dixon is the co-founder and a board member of the Coalition for Community & Healthcare Acquired Infection Reduction ( CHAIR ). He has 40 years of experience in senior administration , planning , design , construction , commissioning plus infection prevention and control in healthcare facilities in Canada and across the globe .
We are all responsible for HAIs and should dedicate our resources and trust in a PC- MDT to lead the way to safer environment for patients , staff , physicians , and visitors . Remember , the word “ team ” has four letters that can spelled also as mate ; thus , we are all teammates .” www . healthcarehygienemagazine . com • july 2023
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