🔒Ross pushes clean hands for patient safety

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When Dr. Jack Ross assumed his role as the director of infection control at Hartford HealthCare in 2013, he noticed a significant cultural challenge: hand hygiene.

“I realized our reported versus observed hand-hygiene numbers were not congruent,” said Ross. “Like many hospitals in America at that time, we were averaging less than 40 percent compliance [with hand sanitation after each patient visit].”

Lack of hand sanitation is a leading cause of healthcare-associated infections (HAIs), a major problem for the healthcare system. According to the Center for Disease Control (CDC), HAIs result in an estimated $30 billion in excess healthcare expenses nationally each year, and are the most common complication of hospital care. In fact, a CDC national survey found that on any given day about one in 25 hospital patients have at least one healthcare-associated infection. And according to 2011 CDC figures, there were an estimated 772,000 HAIs in U.S. acute-care hospitals, with more than 10 percent of patients—75,000 — dying during hospitalizations countrywide.

For Ross, the risk of inconsistent hand sanitation required a concerted effort and cultural shift.

“We wanted to implement a program that followed hand-hygiene guidelines, set goals for improved compliance and actually improved compliance [rates],” Ross said, noting the approach Hartford HealthCare took was low-cost and common sense.

So in 2012 — to get a true, validated picture across all units — Hartford HealthCare allowed one anonymous observer to compile data on hand hygiene. “With the data compiled, executive leadership was able to put hand hygiene as a quality metric,” Ross said, “with a goal of 90 percent or greater compliance.”

The rollout of the program was no easy task, says Hartford HealthCare spokeswoman Tina Varona.

Hospital buy-in

“It took Dr. Ross' solid leadership and high goal setting to bring it to fruition,” she said. “Our staff has responded in record numbers.”

Ross is quick to point out that launching a program across Hartford HealthCare's five facilities, including Hartford Hospital, Hospital of Central Connecticut, MidState Hospital, among others, was a team effort. The program, he notes, was heavily promoted by executive leadership teams, videos, computer screen savers, newsletters and hand-hygiene fairs. Most important, however, has been the support of 200 “accountability agents” across the organization, which document more than 4,000 hand-hygiene observations a month.

“Since the program's inception, more than 100,000 observations have been recorded,” said Ross.

Each week over the past three years, Varona explained, Ross has reviewed the data collected and shared key findings with administration officials, managers and internal staff on a monthly basis.

“Everyone from physicians to nurses to maintenance and food staff have championed Dr. Ross' cause,” Varona said.

While he contends that the biggest challenge the program faced at inception was getting employees to believe their hand sanitation was not as good as they assumed, Ross says the results have spurred some healthy competition across facilities and teams.

“Doctors don't want to be eclipsed by the registered nurses or the intensive-care unit staff at one location by that of another ICU,” he said.

As of Oct. 2015, Hartford HealthCare's compliance rate has increased from 33 percent to 95 percent, one of the best rates in the country, Ross said. And it was largely done on a shoestring budget.

“Compared to per-unit video monitoring, our method is amazingly inexpensive,” he said. “Just one healthcare-associated infection easily offsets the cost [of this program], so there is a larger return on investment.”

“Dr. Ross' commitment [to hand hygiene] has created a domino effect engaging and connecting every hospital employee to this effort,” said Varona. “He has created a national model where patients are safer and less likely to develop infections from staff [interactions].”

In the process, he's not only transformed a health risk, but a culture as well. Two hands at a time.

Profiles of all the 2015 Healthcare Heroes

Dr. Fernando Ferrer, CT Children's Medical Center

Heather Gates, president and CEO, Community Health Resources

Dr. Pauline Olsen, co-founder Malta House of Care

Dr. Jack Ross, Hartford HealthCare

Rebecca Santiago, RN, Nurse Navigator

Ruth Satterberg, Occupational Therapist

Elaine Scheinblum, RN, onclology nurse

Interim HealthCare

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