LeanBlog Podcast #65 – Kevin Frieswick on Error Proofing Hospital Handwashing
LeanBlog Podcast #65 is a discussion with Kevin Frieswick, a Lean Process Manager, with MetroWest Medical Center in Framingham, MA. I found Kevin earlier this year when I discovered their YouTube video about innovations at MWMC, which included a unique error proofing device to help encourage hand washing by staff and physicians before entering patient rooms. In this podcast, Kevin gives us more details behind the invention of the device and how it has been received in the hospital.
My podcast with Kevin is below the original video, shown below (update: the video was removed in 2014 at the hospital's request).
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This is a great idea, but how do they handle when a patient codes?
We addressed this two ways. The “tollgate” bar is flexible and you can walk/run right through it in an emergency. It also is counterweighted so it can rest in the upright position with a subtle flip. These features are in place for emergencies and also done to allow easy access when moving patients in and out of the room as well as for cleaning.
I really like the video on Poka Yoke for hand sanitizers in hospitals.
The authors/inventors seem to be getting close to a workable solution.
I'm wondering if there might be a way to combine a couple of things to improve how often healthcare professionals sanitize before serving their patients.
As I understand it, caregivers must log their interactions whenever they are in close contact (serving or attending to; not sure of the wording here,) a patient. Much of the rest of what I have to say is based on that potentially incorrect assumption; so please bear with me.
If caregivers must "log" the interaction each time it occurs, you could use an RFID device that could trigger the hand sanitizer, and also log that it was activated and when.
Then it would only be a matter of comparing the "patient care log" with the "sanitizer's activation log."
It wouldn't guarantee anything, (mistakes could still be made,) but it would be a pretty good way of tracking who is sanitizing and who is not, and how much.
The implications of this could be very far-reaching. Of course Dr. "x" only sanitizes 87% of the time; that might hurt his or her performance appraisal, be supporting evidence in a malpractice case, and/or be a great motivator etc.
Another thought; you could put a computer at every bedside (or a mobile "rounds" computer,) that only operates when an "authorized caregiver" wearing the right RFID tag sanitizes (bedside.) Basically, the dispenser "wakes-up" the computer and logs the start and stop time of the interaction. This has huge implications far beyond tracking sanitization as you can imagine!
Very often there may be more than one caregiver serving the patient at any given time, so (if that is a required part of the log,) the data would still track activation of the dispenser and all who activated it, as opposed to who should have.
Hey, I can go on and on…; – ) I haven't even said anything about "light curtains" around patients with lights and buzzers that are only disarmed by connected and activated sanitizer dispensers ; – )
I always enjoy your work Mark! I don't think I've solved the entire problem or anything, but I hope this post stimulates further thought and discussion.
All the Best,