Have You Washed Your Hands?

Hospital acquired infections can prove a serious danger to unsuspecting patients—especially those already vulnerable due to illness and such.  Inadequate hygiene practice on the part of doctors and nurses is often the culprit.  Simply put…that can mean forgetting to wash one’s hands before coming in contact with a patient.  Proper hygiene practice is more than merely the washing of one’s hands, but it’s certainly a big (and obvious) part of it.

Kaiser Permanente ( a well-known health care provider in my area) tackled this problem head-on…even if it meant taking on some sacred cows.  I learned this first-hand while aiding my 83 year old mother during her pre-surgery orientation at the hospital.  The nurse explained what was expected of my mother (i.e. no fluids after midnight, no wearing of any jewelry, etc).

Most of the instructions were predictable, but there was one big surprise at the end.  “Now there’s one last thing you must do any time any of the nurses or doctors are about to treat you.”  “What’s that?” my mother asked.  The nurse smiled, “Ask them if they have washed their hands.”  My mom wasn’t sure if the nurse was serious.  ”You’re kidding, right?” my mom asked.  The nurse absolutely was serious.  Turns out, every patient gets the same request about asking the staff if they have washed their hands.

My mother was unaccustomed to asking her care givers (doctors especially) such questions—largely for fear of offending them.  Certainly, she wasn’t bashful about asking more technically-oriented questions.  But the ‘hand-washing’ thing threw her for a loop.  At first she thought it demeaning to ask a specialist who has a gazillion years invested in training the same question she used to ask me as a little kid before we’d sit down for dinner.  These aren’t children, she argued.  She concluded that the question was too basic, too fundamental to really have any real impact.  Plus, the last thing you want as a patient is to have your care-giver get ticked-off at you.

But later, in a moment of bashful curiosity, mom (in her own round-about way) asked the ‘hand-washing’ question of her surgeon.  He wasn’t offended in the least.  In fact, he thanked her for asking.  That was all it took, mom began to ask the ‘hand-washing’ question all the time—at times shamelessly.    It seemed she even took some small measure of delight in it.

The sacred cow (the inquisition of a doctor by a lay person questioning the doctor’s commitment and discipline) had been put out to pasture.   Hooray for Kaiser— and other like-minded health care providers—- who have accomplished this marvelous breakthrough.  Their culture is now healthier…more capable of delivering  even greater health care results…far less likely to unintentionally infect a patient….all consistent with mind-set #1 which is all about having a bias for results.

Each organization has their own sacred cows that retard the health of their organization’s culture.  As Kaiser demonstrated, sacred cows can be overcome with commitment and perseverance.

In your organization, what sacred cows would you like to put out to pasture?

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