Many initiatives of safety and quality improvement to prevent and control hospital-acquired infections have failed. They have been unmeasurable or have ignored clinical outcomes.
Culture often determines and limits strategic planning efforts in large complex organizations. Organizational culture enacts extreme resistance to efforts at changing policy and practice. Organizational dynamics and structures prevent improvement at multiple levels of analysis: the industry, the institution, the department. Therefore, quality and safety interventions aimed at changing collective work practices are unlikely to be sustained beyond the intervention period itself.
To get at the root of the infection issue, it is necessary to approach the culture of the hospital, on a unit-by-unit basis, to really understand what hospitals are up against in order to design and implement strategy.
Hospital and its participating staff: Physicians, Physicians’ Assistants, Nurse Practitioners, Registered Nurses, Licensed Practical, Nurses, Radiology Technologists, Other Technologists, Aides
First: Focus on psychological processes of the individual, rather than the normative behavior of the group. Review the key psychological principles that govern the cognition and behavior of individuals.
Second: Target specific behaviors among staff by levering the survey results which provide a foundation for quality and safety interventions. A focus on the individual, rather than the group, can change patient safety behavior on the hospital’s front lines.
Third: Using the survey model, draw a broad set of theories and principles concerned with changing the behavior of the individual, rather than trying to redirect the herd. In contrast to efforts toward change directed at groups of people, individual behaviors can be highly receptive to change.
Fourth: Use the survey and assessment to highlight the challenges the individual faces to improve quality and safety and then, highlight those interventions that will be the most successful, based on the culture of the unit.
Fifth: Invite front-line staff to participate anonymously to help identify the challenges facing hospitals, to enact the change needed for improving patient safety. Invite clinical staffs to complete the Risk, Behavior and Culture Survey developed by Infonaut who built into the software an incentive feature to motivate and award stakeholders up to 1.25 hours of professional continuing education credits.
Sixth: Use the results to identify both obstacles and opportunities for introducing specific interventions on a unit-by-unit basis. The survey model serves as an instrument to learn about clinical staff perceptions of their information use habits and norms, and perceptions of patient safety and the role of management.
Seventh: Present to staff the results of these measures which act as a baseline measure for interventions targeting staff attitudes and dynamics. The survey specifically measures:
1. Unit attitudes to patient safety;
2. Unit capacity-to-learn as a group;
3. Unit information culture; and
4. Personal perception of risk.
Eighth: Follow-up retesting after a set period (i.e. a year) to determine measureable change in culture based on the effective interventions and relationships.
D. Benefits of the Technology
Infonaut is useful for solving the challenge of deadly hospital infection through their proprietary real-time surveillance, analytics and behavior improvement platform. Data sets of population health, public health, data-warehousing and privacy were referenced to develop innovative platforms that use the power of location technology, and B.I. systems for disease and infection surveillance.