Patient safety, hand washing and hierarchy

Last week during Patient Safety Awareness Week, the next interview from the New York Times caught my attention. In , Dr. Peter J. Pronovost, medical director of the Quality and Safety Research Group at Johns Hopkins Hospital in Baltimore, describes his patient safety efforts after a father was misdiagnosed and a toddler died from a catheter-related infection.

At one point within the interview, Dr. Pronovost talks about improving medical handwashing practices. Part of the answer was to have nursing staff be sure that doctors washed their hands, and if doctors didn’t wash their hands, the nurse could stop the procedure. The following excerpt from the interview shows how each nurses and doctors reacted:

An excellent result, right? Yes, but this strategy was not initially well received. Later within the interview, Dr. Pronovost discusses the advantages of empowering nurses and avoiding the hierarchical structure present in many settings. As nurses, we spend most of our time with patients, we’re aware of subtle changes of their condition, and we’ve a responsibility to talk up when patient safety is in danger. Under the identical principles, we even have the fitting to be heard. In short, for a team to achieve success, mutual respect and effective communication are essential.

How good do you are feeling in your team? What approach would you are taking when reminding a colleague (nurse, doctor, or anyone else) to scrub their hands?