Great article, Go Gadget go…

As Martin Luther King says as well ” Everybody can be great because anybody can serve. You don’t have to have a college degree to serve. You don’t have to make your subject and your verb agree to serve. You only need a heart full of grace, a soul generated by love.”

So how can this be applied to a hierarchical health care system? Just one example from the Positive Deviance approach: At the VA hospitals in Pittsburgh, Dr. Jon Lloyd is spearheading a drive to conquer methicillin resistant staphlococcus aureus infections (MRSA).

Here is an excerpt from the article “Do What you Can, With What you Have, Where you Are.” by Arvind Singhal, Karen Greiner, and Prucia Buscell

Culture change is clearly not the objective of the Positive Deviance MRSA project, but it is happening. When every single person in the organization in invited
to tackle a problem, transformations begin in entrenched traditional hierarchies.

The story of Edward Yates, a member of the housekeeping staff, is one striking illustration. Mr. Yates had been interested in the initiative from the beginning, and had surprised doctors with his knowledge that Chlorox, not alcohol, is needed to kill spores of Clostridium Difficile, or C-Diff, another virulent antibiotic resistant bug. Mr. Yates was later chosen by unit staff to conduct one of the regular MRSA briefings for some 15-20 staff members, including leading physicians. All
present shared pride as he reported that the Heinz’s 2 South Unit had no MRSA infections, no colonizations, and had achieved a 100 percent swabbing rate.

To Jerry Sternin, the fact that a well-informed member of the housekeeping staff was informing doctors and administrators at the top of the hierarchy, was one of the most gratifying instances of cultural change in action.

Examples of in-house expertise abound, once people start looking. Darryl is a veteran in his 30s who acquired a MRSA infection at VAPH and has endured four surgeries at the site of his infected leg wound. He devised his own polite way of fostering hand hygiene. When doctors or nurses enter his room without washing their hands, he said, he avoids eye contact with them, and looks instead at the sink. If the offender is impervious to subtlety, he added, “I just look back at the doctor, then back at the sink, until they wash their hands.” Wall signs urging EVERYONE to wash or sanitize hands are another focus for a patient’s gaze. Darryl has shared his strategy with dozens of other veterans, adding advice to signal with a smile, not a smirk. He emphasizes that patients can be part of the solution, not the problem.

Read more here:
http://www.plexusinstitute.org/complexity/index.cfm?id=3

http://www.plexusinstitute.org/ideas/show_elibrary.cfm?id=1182