Page 107
INFECTION PREVENTION
streaming scores — without mentioning any names — on wall-mounted digital scoreboards, compliance quickly zoomed to nearly 90%. Now, scores for each shift are broadcast on hallway scoreboards that flash "Great Shift" when staff compliance tops 90%. That's a real motivator.
Another partner, Forest Hills Hospital in Queens, N.Y., also wanted to see whether video monitoring could improve how the ORs were cleaned between procedures. There are 10 items on the cleaning checklist — miss one, and you fail. Before they started monitoring, they were a complete bust, achieving perfect compliance 0% of the time. Now they're close to 100% in that area, too.
Monitoring also ensures that overnight cleaning processes are followed, another important factor in reducing the risk of surgical site infections. Terminal cleaning compliance has improved to almost 100%. The hand-washing program helped us learn a powerful lesson: People change behaviors when they know they're being monitored and they see the results of compliance.
Hold everything
From there, we've recently expanded the program to improve on the surgical time out program we rolled out in 2008. The idea at the time was to systematically cover all procedures related to the OR, with a special focus on preventing wrong-site surgeries. Unfortunately, the time outs didn't succeed the way we hoped they would, so we began looking for better ways to motivate staff and improve compliance.
Two breakthroughs made the difference. One was identifying the anesthesiologist as the logical candidate to take leadership in implementing time outs. The other was auditing video. When we did those things, compliance with time out procedures almost immediately shot
