“I enter a patient's room to take care of her trach (breathing tube) and to provide
suctioning. Her son states, "Watch Miss Denise." Of course I feel like I am on camera. When I am finished, he comments to his mother:” Did you notice what she does that the nursing home personnel is not doing? WASHING, USING GEL, GLOVES AND USES GEL AGAIN WHEN COMPLETED.
He states to me that everyone who has been involved in his mom's care from ICU to GMF, on 2 different admissions, are the best and that ALL employees wash, gel and have gloved EVERY TIME and that maybe Einstein needs to go to this Nursing Home and teach them.
This made me feel so proud to be a member of Einstein's team.”
PD In Action
“While observing hand hygiene practices on one of the nursing units, I saw our Jasper (a patient escort) arrive to pick up a patient. He was a bit down the hall from me but I could hear him talking to a PCA in a room across the hall who had just disposed of an isolation gown, a bit sloppy for Jasper's liking I guess. I could hear him saying "There's a way to do that so there is not so much trash." After hearing him explain it, she said, "I don't understand."
With that, he took a short break from his duties and grabbed an isolation gown saying "OK, isolation gown removal, here we go," and proceeded to demonstrate his "method" right there in the hallway.
I just thought this really demonstrated a leadership quality that should be acknowledged and shared.”
Another Step in Changing the Culture
“I just wanted to report some great news from the medical residents’ initiative based on the SMASH. Based on fairly poor compliance with hand-hygiene and gloving/gowning amongst the residents, a group of residents got together and developed a campaign to improve compliance.
They developed a competition between the Interns and 2nd/3rd year medical residents on which group would do a better job washing their hands and appropriately glove/gown.
The campaign was kicked off with a brief educational session (10min) for all medical residents and a small “token” (a handheld sanitizing spray) was given to everyone to carry in their white coat pocket as a reminder. This was simply followed by ongoing encouragement and reminding of their peers on the floors when necessary and leading by example.
At the end of this campaign the overall compliance amongst senior residents had improved from 20% to 50% (with hand hygiene upon entering the room being the worst) but not enough to beat the Interns who ramped their overall compliance to 83%!!
We hope that this is another important step towards changing the cultures. And we hope that the Interns will sustain and further improve their performance as they move on to be the new seniors and lead the incoming Interns by their example.
I would like to thank everyone for their support and encouragement to pursue this project, especially Drs. Sivak and Eiger who gave their full support to the residents doing this project.
And please join me in giving Kudos to the three main protagonists in this resident campaign:
Joyce Epelboim (PGY-2), Kim Jegel (PGY-1) and Paul Schurmann (PGY-1).”
PD Quotes from the Field
“PD is like a flashlight. It helps to shine light and illuminate what hides behind the darkness. It helps us discover what already exists. For example, it helps us discover our existing strengths we had not realized or utilized.”
~a kader, Kedoyo, Indonesia
“The PD approach is like digging with a hoe. One needs to turn the soil over to see what lies hidden and buried beneath. Then the land is ready to plant new crops.”
~Raymond, community leader in Pader District, Indonesia