Posted by: knightbird | June 3, 2011

Hospital Acquired Infections in Alaska

The Providence Alaska Hospital is faced with a MRSA epidemic in its newborn intensive care unit, as reported by the Anchorage Daily News (ADN) on June 2, 2011. [i] As reported in the article, they typically see between 10-12 cases annually throughout the hospital. This is happening at an institution that says it recently received awards from the National Quality Form and The Joint Commission for its work on eliminating blood stream infections related to catheters (possibly central line infections, maybe urinary, the article is not clear). It’s good news that serious problems with health care make the daily newspaper. Overall, it’s estimated that as many as 100,000 deaths are caused annually by hospital acquired infections. [ii] The good news is that Providence is adopting Lean Healthcare as its culture.

One of the comments to this article is interesting. The author states: “A member of my family was recently in ICU, the staff was wonderful, BUT the cleaning lady wiped down the toilet and then the counter and sink with the same cloth!!!!! Maybe if the hospitals spent more money on training their cleaners, there would be less of a problem!”

I blogged about Chugachmiut’s cleaning for health initiative some time ago, and noted that our cleaning contractor not only uses different colored rags and mops for different parts of our clinic, but they also launder each batch of rags and mops separately. The author of this comment is dead on. We need to provide our patients with a sanitary facility, using standard work proven to eliminate pathogens and train our cleaning staff to adhere to the standards. Lean Healthcare led us to our cleaning for health protocols.

Now the tools of Training Within Industry[iii] are leading us to train our cleaning staff in our village clinics to follow the same standard work.

Providence is apparently adopting Lean Healthcare as an organization wide management system.[iv] I learned years ago that Providence Alaska hired and trained a six sigma staff that struggled to achieve in the cultural environment at Providence. It now appears that they are gathering some improvement momentum with lean events. With MRSA prevention, the Veterans Administration (VA) and the Pittsburgh Regional Healthcare Initiative (PRHI) have combined to utilize the Toyota Production System to set a goal of zero infections through their “Getting to Zero” initiative.[v] There’s hope.

My takeaway from the ADN article is that Lean is slowly spreading to some Alaska healthcare providers, that cleaning standard work and training needs to valued, is critical and that great work on MRSA prevention has been done nationally that can be adopted here in Alaska. My fear, that someone will bypass adoption of a lean thinking culture and package the Getting to Zero concept into what Dr. Stephen Spear refers to as “one-off interventions.”[vi] These interventions are packaged solutions marketed by consultants to executives who force the solution on their employee’s with the hope that things will get better.


[i] Rosemary Shinohara, “Staph infections plague Providence infant care unity,” Anchorage Daily News, June 2, 2011

[ii] Kevin Sack, “Hospital Infection Problem Persists,” New York Times, April 13, 2010

[iv] Nora Haile, “Lean in 2010: Are Healthcare Systems There Yet,” Washington Healthcare News, February 2010

[vi] Spear, Steven, “Why Best Practices Haven’t Fixed Health Care,” Harvard Business Publishing [HBR.org] (January 3, 2011)

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Responses

  1. You make great points.

    I had not read your post about the different colored clothes to prevent the spread of organisms. Appreciate you posting this. What a great example of an elegant and low tech strategy. The work you are doing serves as inspiration to those committed to driving defects in health care to zero. Thanks again!

    My best,

    Anna Roth

    • Hi Anna. Good to hear from you. I blogged about our Cleaning for Health initiative on June 29, 2011. I would be happy to share our powerpoint with you if you would like.

  2. Hey, very nice site. I came across this on Google, and I am stoked that I did. I will definately be coming back here more often. Wish I could add to the conversation and bring a bit more to the table, but am just taking in as much info as I can at the moment.
    iso 9000


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