Hospitals to dirty-handed employees: We'll be watching you

[cougarnurse]

From the Wall Street Journal: Health Blog : Hospitals to Dirty-Handed Workers: We'll Be Watching You

When it comes to preventing infections in hospitals, one of the toughest challenges is getting health-care workers to wash their hands. Seems basic, but studies show compliance with hygiene rules is often less than 40%.

Now a company called Arrowsight is bringing to bear a Big Brotherish solution that has worked in food processing and manufacturing plants: a video surveillance system that measures adherence to hand-washing rules and provides hospitals with quick feedback on the laggards.

To pitch the system to hospitals, Arrowsight is tapping Suzanne Delbanco, 40, who most recently was CEO of the Leapfrog Group, the national coalition of large health-care purchasers that includes heavyweights like General Motors and Boeing. Leapfrog, created in 2000, aims to prod hospitals to provide safer, higher-quality care and reward them for a better job with payment incentives.

Though Arrowsight can’t yet say what it will charge for the watchdog service, Delbanco tells the Health Blog the company is working with a major academic medical center that she declined to name on a major pilot program. In an earlier pilot, launched in January of 2007, the company says its hospital video auditing service boosted hand-hygiene compliance to 90% from 38% in three months. The improvement was durable, remaining above 90% for twelve months running.

Hospitals have fresh incentive to at least consider such steps: Medicare and many private insurers won’t pay for the extra costs of treating preventable infections starting next October.

“There are lots of things that can only be measured visually that we hope to be able to use this methodology for,” such as protocols requiring nurses to turn patients at risk of bedsores on a regular basis and to follow specific rules for placing central lines and urinary tract catheters, Delbanco says.

While live auditors won’t be monitoring worker’s every move 24/7, the Arrowsight system is programmed to search huge volumes of video very efficiently. It’s smart enough to catch such triggers as a door opening to a hospital room to capture whether staffers washes their hands after entering. (For more, see Arrowsight’s promo video at right.)

Though it may sound like a “nanny cam” for nurses, Delbanco says the aim isn’t to nab offenders or punish those who are non-compliant, but rather to provide information that can help hospitals rehabilitate the scofflaws and work with medical teams to ensure better compliance.

“More than anything the challenge is creating sustained improvement in health care,” says Delbanco. Compliance measures such as posters reminding staffers to wash their hands haven’t worked, “and after a month they don’t even see the signs anymore,” she adds. “This is a loop of ongoing feedback that never goes away.”