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Hospital Resorts To Cameras To Ensure Employees Wash Hands
onehitwonder writes "Long Island's North Shore University Hospital is using sensors and video cameras to make sure employees wash their hands, according to an article in today's New York Times. Motion sensors detect when hospital staff enter an intensive care unit, and the sensors trigger a video camera. Feeds from the video camera are transmitted to India, where workers there check to make sure staff are washing their hands. The NYT article notes that hospital workers wash their hands as little as 30 percent of the time that they interact with patients. The Big Brother like system is intended to reduce transmission of infections as well as the costs associated with treating them."
On Slashdot to wash my hands!
Ewww.
Check out my sci-fi/humor trilogy at PatriotsBooks.
One puzzle is why health care workers are so bad at it. Among the explanations studies have offered are complaints about dry skin, the pressures of an emergency environment, the tedium of hand washing and resistance to authority (doctors, who have the most authority, tend to be the most resistant, studies have found).
But... hang on a bit... how come 20 years ago this wasn't an issue?
Questions raise, answers kill. Raise questions to stay alive.
Wouldn't surprise me if for some of these employees, the workload is just too big to be able to clean your hands after every treatment. I am not saying that its ok to not do it. But hopefully if a reason why so few employees do it is found, it will be taken care of. We have all had jobs where you had lots of safety rules and a bos which insisted you followed them, but also insisted that you worked faster than the safety rules could possibly allow you.
Feeds from the video camera are transmitted to India, where workers there check to make sure staff are washing their hands.
Just for a moment, I flashed back to 1994, and all the miraculous possibilities that this thing called the Internet could bring to society if it happened to catch on.
Never had it occurred to me that we would run a camera halfway around the fucking world so that India can make sure a nurse anesthetist properly washes his hands after pushing brown. Not even close.
Part of the problem is that the medical education system is deliberately set up to ensure a continuous shortage of doctors. As a result, all doctors have extremely high pay and are almost immune to any kind of employee discipline; they know that the hospital needs them more than they need it. We let the AMA run medicine like a medieval guild, while almost everyone else is exposed to ruthless market competition – it's no wonder that we get nonsense like this, and that health-care costs have been rising faster than inflation for decades.
You're Cube Man #3,948 and every day, for 8 hours straight, you watch these TV feeds. It all looks the same. There is no audio. There is nothing interesting happened. Whenever you see someone wash their hands, you push a button.
Pop quiz: How long before you're bored senseless and start making mistakes... or not caring?
Psychology tells us that repetition and boredom leads to mistakes. This system is a band-aid, it does nothing to address the environmental conditions that are causing the behavior -- those are what need to be tweaked. You cannot make lasting changes to a person's behavior through threats, manipulation, guilt, and shame. Temporary, yes. But it wears off, and you're left with the situation of having to increase the level of abuse repeatedly, creating a vicious cycle that demoralizes people and makes them resentful.
Is that really the psychological state you want a guy whose job it is to cut people open and prescribe them powerful and potentially deadly medications? Come up with something better, people. This kind of social engineering has never been effective. The airline industry licked this problem a long time ago -- they're called checklists, copilots, training, and redesigning the environment and paying close attention to work loads. And the reason all of that was implimented is because the government got sick of corporations cutting corners on safety, training, and creating cultures of fear.
More people now die in hospitals than plane crashes. I think if government regulation of the industry worked to reduce the risk of flight to such a low level that it has become the safest mode of transport, that we can at least make our hospitals achieve half of that success. 30% is pretty damn pathetic, guys.
#fuckbeta #iamslashdot #dicemustdie
...apply electric shock punishment remotely to offenders?
Shades of the Milgram Experiment...
Doctor's may be immune to discipline but nurses are not.
Nursing schools are cranking out young, low wage nurses, for which the hospitals are looking for any reason to get rid of the higher paid and older nurses... I know a nurse, she's in her 50s, been an RN all her life and still is forced to work x-mas and Thanksgiving otherwise her hospital will replace her with the girls coming out of the local nursing school.
Reminds me of the programming industry...
I'm picturing an xbox kinect-ish system that tracks each person entering, follows their movement and the movement of their limbs, and remembers if your hands got close enough to the sink / sanitiser. Then only if you head towards ICU and attempt to open the door, an alarm sounds so that your peers in the room notice, and a video recording is kept.
09F91102 no, 455FE104 nope, F190A1E8 uh-uh, 7A5F8A09 that's not it, C87294CE no. Ah! 452F6E403CDF10714E41DFAA257D313F.
half of that high pay can go to insurance to pay off ambulance chasers
It still doesn't excuse his behavior, micro managers like this are an everyday thing across all industries and they invariably demoralize staff and hold back companies. So here he's been allowed to put cameras in the toilets and monitor staff for 'cleanliness', which inevitably means he monitors them for frequency of toilet breaks.
It's micro-managing and a well understood to be an incompetent trait.
Presumably Indian staff will be promoting this as a good thing, 'outsource your micromanagement', hence the -1 on the score, but the influence of doctors really doesn't excuse the managers incompetence:
http://en.wikipedia.org/wiki/Micromanagement
Effects
"Regardless of a micromanager's motive for his or her conduct, its potential effects include:
" Creation of ex post resentment in both "vertical" (manager-subordinate) and "horizontal" (subordinate-subordinate) relationships
"Damage to ex ante trust in both vertical and horizontal relationships
"Interference with existing teamwork and inhibition of future teamwork in both vertical relationships (e.g., via malicious compliance) and horizontal relationships "(e.g., exploitation of moral hazard created by poorly proportioned effort-reward structures)."
Note the terms like 'malicious compliance', where such incompetence pisses people off so much they do out of there way to do the opposite. This is a common effect of such incompetent leadership.
The country is well known to have a hygiene problem. Public defecation is rampant and hot topic in the international press. Couldn't they at least out sourced to a country that is at least clean, if not cleaner than us like the Japanese or one of the Scandinavian countries?
The NYT article notes that hospital workers wash their hands as little as 30 percent of the time that they interact with patients.
Actually the hospital workers wash their hands as little as 30 percent of the time that they interact with patients if not encouraged to wash hands.
The other issue is that every interaction with a patient does not necessitate washing of hands. For example, walking into a treatment room and stating "the doctor will be in in a minute" does not require washing of hands.
Yes, we all noted the irony of having people in India monitor hygiene practices.
But you don't need to be suck a dick about it. Oh wait, you're an AC, so yes, you do.
I can't stand the pillar the medical profession puts itself on. Let's run down the list of examples for how the medical profession doesn't give a shit about patients, shall we?
Please help metamoderate.
So they don't trust their hospital staff to wash their hands, but they do trust Indian staff to report them.
As the article says - it is mostly about cognitive load. People focus on the hard things and forget the easy things. Checklists deal with exactly the same phenomena and have produced great results in healthcare as well as exactly the same bogus complaints about lack of trust.
The article points out that something like 100,000 deaths per year are due to infections acquired while the patient was in the hospital and dirty hands are the primary means of transmitting those infections between patients. This is a problem that absolutely must be fixed. simple "trust" has not been sufficient so far.
The indians who do the watching do not have any harder problems to distract them. They may grow bored, like anyone who has to watch the same thing over and over again, but that's manageable. Maybe they give the indians a bounty to encourage them to focus, maybe they just rotate them through other tasks frequently enough that boredom does not overwhelm them.
When information is power, privacy is freedom.
This is not special to America, in France where I live, medical studies are being severely subject to quota, the result is that the country must now import doctors from other parts of the world, especially Africa, the Middle east and Eastern Europe, when there's lots of unemployment in other fields, and while the country has perfectly all the abilities to train its own doctors. In the same time, those parts of the world are badly missing those migrating doctors.
Would be to educate the employees why it's important to wash their hands... This would mean nobody's privacy gets violated, people in the developing country wouldn't have to do the horrible work of gawking at the mind numbing video feeds and the patient who's handler inevitably forgot to wash his hands and whose gawker missed this infraction wouldn't get seriously ill.
But hey, that's just a suggestion. Reading news like this makes one think the whole world has gone insane.
Alcohol is bad for the skin, while soap has proven to be just as effective at germ removal. So I'm fine with this monitoring if one of the options is to use regular soap. Otherwise they might as well add an injection station where you have to stab yourself with the medical elixir du jour before leaving the restroom.
I come here for the love
Wow, these guys are employing chaps across the world to do the job, when we built our autonomous android-based solution at a hackathon last year? Only sad fact, the community for whom we built the concept (schools here in Uganda mostly), never understood the idea... or we were not entrepreneurial enough to push it beyond the initial hacks.
http://www.youtube.com/watch?v=Mg4t3u8psQU&feature=share&list=PL9nqA7nxEPgsuV4Rfs0B-oN_O2pk_ddm4
(this was in 2012, at the Sanitation Hackathon, Kampala, Uganda).
You're a racist piece of shit.
Doctor's may be immune to discipline but nurses are not.
Nursing schools are cranking out young, low wage nurses, for which the hospitals are looking for any reason to get rid of the higher paid and older nurses... I know a nurse, she's in her 50s, been an RN all her life and still is forced to work x-mas and Thanksgiving otherwise her hospital will replace her with the girls coming out of the local nursing school.
Reminds me of the programming industry...
Are you saying that if you get sick on Thanksgiving it would be best, medically speaking, to only have inexperienced nurses treating you? As a patient, you would feel okay knowing that the experienced nurses were home with their families, while you were being treated by newbies?
Battlemaster--Game with friends in medival realms
or virtually any other industry, actually.
Let's all be grownups here and overlook that Freudian typo.
I suppose you'd probably hide all those gadgets if you were selling this commercially... but somehow it feels like being as electronically obvious as possible about wanting people to wash their hands might do the trick of shaming them into it.
Very cool.
Many, many studies have shown that this type of method is less effective than proper training and motivation.
Would be better to find out why the people are not washing their hands, and fix that problem.
Lack of knowledge, facilities?
Here's an article about a better way to do it; looking at the entire system and finding ways to make getting good hygiene simple and faster.
(OK, it's from a hand-dryer company, but still illustrative of the approach.)
http://www.exceldryer.com/presskit/CaseStudy-NMH.php
People didn't get sick or hurt on weekends 50 years ago? She knew working holidays and weekends wa part of the job when she went into the field.
Time is what keeps everything from happening all at once.
He trusts an NYT story quoting an unnamed survey more than his own staff. If he doesn't trust his staff, why should anyone else?
"when the workers have shown such gross negligence as to actually infect more patients than they manage to cure"
Says the NYT story quoting some made up statistic dreamt up probably by a company marketing something. Like surveillance cameras for was rooms.
" If you're a doctor/nurse, shut the fuck up and start washing your hands "
Clueless. I hope you're not a manager because you're incompetent.
they don't trust their hospital staff
When it comes to health, someone needs more than trust.
Slashdot, fix the reply notifications... You won't get away with it...
This is clearly a press release from a company marketing the system. It's common for marketing bods to commission fake surveys justifying their products.
So they make the accusation that this is common and that using these cameras to spy on people fixes it, and some manager is such a gullible prick he installs it against his own staff. The most likely outcome of that micromanagement is demoralizing counter action.
He's an idiot. If he truely believed his staff aren't washing there hands, there's constructive ways and destructive ways of tackling it, and he's chose the most destructive counter-productive approach. Spying on his staff's toilets.
That's actually life in a hospital -- there is a set of holidays that the hospital assumes people want off, and they usually do a rotation of which holidays which years. Also, 12 hour shifts 3 days a week are quite common. (And as there a 12 hour shift means 12 hours really there, it's more like 13-14 when you have to be there early even if there's four feet of snow, and you stay after if you're dealing with a patient.)
Most nurses prefer to transfer to doctor's offices where they can work more normal hours, but the pay is much less, so usually when they're young they go for hospitals for decent pay, and then if they get married often they can afford to get out of that system. Doing 12 hour shifts for decades takes a toll.
If a general practitioner saw only 2 patients an hour they would only wash their hands ~18 times during an 8 hour shift. If they see 5 patients an hour that jumps to 40 times. Forget tedium, this sounds to be a dermatology problem.
Easy fix:switch to UV LEDs. A tanning bed for your hands and copper door nobs will go a longer distance than scrubbing your fingers to the bone in order to comply with a policy.
i like this article and i fully agree with them
Is there a doctor in the house?
The down side to your model is that private hospitals have an incentive to increase the price to you as much as possible. If their operating model is to increase revenue to shareholders then there will be a drive to find financial profit where ever possible.
They need soap that will make their hands turn purple after 1 hour, unless they wash their hands again. Using people in a 3th world country that has absolutely no idea about higiene, to watch the higiene of people in a 1st world country that are supposed to be educated about it, is rather ironic.
Excuse me, but please get off my Pennisetum Clandestinum, eh!
Something is very wrong somewhere
First, in UK hospitals, the following happened ...
http://www.disclose.tv/forum/uk-allows-muslim-nurses-to-not-wash-to-protect-their-modest-t87289.html
Now, in US hospitals, they have to snoop on their staffs, and then send the video feed to India, where they got many pairs of cheap eyeballs to spot those who have failed to wash their hands
What has actually happened to common sense ?
Muchas Gracias, Señor Edward Snowden !
Some of them, not all.
Ever heard of a rota, fucktard?
Bullshit!
If you're MURDERING patients by deliberately not washing your hands and infecting people with diseases, you can bet your ass that you are not needed anymore.
India is soon emerging as the "global brain", catering to the rest of the world. It can deliver complex image/video processing tasks like checking if somebody is washing their hands. India can do natural language processing by understanding queries and responding to them. India is like a remote server serving up AI over the network at unheard of prices. Else where in India - scores of "engineers" are lined up for job interviews to show off their prowess at identifying if a person is wiping it properly or not.
Wouldn't it be better to terminate them.
Yes, of course. Being a nurse myself for the last 20 years I know of rotating holidays. They are a pain in the ass.
Time is what keeps everything from happening all at once.
And by the way, people get hurt or sick everyday, whether it is a holiday or not.
Time is what keeps everything from happening all at once.
Assuming that is true. You think stupid people don't get bored?
Everyone gets bored, it doesn't take intelligence to get bored.
1. The evidence is a unnamed 'survey' accompanying a puff piece for this camera system that pins the blame on hand washing. i.e. bad science. Basing decisions on bad science isn't good management, and adding the word 'safety' doesn't make it good science.
2. The consequence of bad micro management is an effect known as malicious compliance, it's well understood, it has the reverse effect of desired.
Really, you guys need to understand the basics of management here. Sticking cameras on people based on a marketing survey isn't a good thing to do, it is destructive to the work environment and will lead the opposite of the desired effect.
Your comment was patronizing, and didn't address the basic management flaw.
Look at the number of doctors per capita in each country and see how bad it is here (in the US).
Wow, sent an e-mail as suggested when clicking on "use classic" banner, and got a fast response that addressed my msg
Didn't you know, people check the rotation before they get sick.
Give each a pass card that's charged at a wash station, the charge is only good for 30 minutes or so. Don't let them do stuff without a charged card. Put an led on it to show its charge level.
Or it can be passive with an RFID that gets logged when they wash their hands, then hold them accountable.
A fool throws a stone into a well and a thousand sages can not remove it.
every successfull fast food/retail chain uses micromanaging horse-shit.
its about time doctors had to be as consistent and quality-oriented as the fry cooks at mcdonalds, especially when a major cause of death is medical errors.
But... hang on a bit... how come 20 years ago this wasn't an issue?
It WAS an issue 20 years ago. This has been a huge issue for a long time. It also turns out to be a shockingly difficult problem to solve. I've actually worked in an infection control department (about 10 years ago) at a hospital and seen first hand the difficulty they had in getting people to take basic hygiene measures to control hospital transmitted infections. Part of the problem is economic, part is attention, part is habits, part is social, part is work process design. Kind of like spam there seems to be no simple and universally effective solution to the problem.
So 10 points higher than the US average?
That's life. Deal with it. You also get worse treatment during certain hours, and on certain days. ( There are studies, not bothering to find them )
20 years ago hospitals could hand out antibiotics like candy to deal with bacterial infections.
You seem to be implying that just prescribing antibiotics solved the problem 20 years ago. Not true. This was every bit as big a problem 20 years ago. The only difference was that we didn't pay as much attention to the problem back then. Sure there are some new complications relating to antibiotic resistance now but that was part of the equation back then too. The problem is one of prevention, not treatment. No amount of antibiotics can solve the problem and even if they could, prevention is MUCH cheaper and more effective.
We let the AMA run medicine like a medieval guild, while almost everyone else is exposed to ruthless market competition ...
Therefore we should expose doctors to "ruthless market competition"? No. We should be tempering labor laws and industry regulation to ensure high quality staff, not pretending that the market is a cure-all.
Ironically, conservatives in the US argue against "socialist" medicine, while holding up the US medical system as the best in the world. Can't be both a "medieval guild" and an exemplar of capitalism. I'd say its closer to a guild and that's part of why it works so well.
tomorrow who's gonna fuss
However, once you where finished washing, you had to pull open the bathroom door by a fairly greasy/grimy handle.... Made me glad to be able to knee the door open when entering, just before I was about to handle my privates.
I typically use a paper towel to open the door and then throw it in the nearest trash receptacle afterwards. If the company doesn't provide them you can of course keep some napkins in your desk for the purpose. A tad OCD I'll admit but I know a lot of doctors who recommend the practice. Of course a better solution is to design entrances and exits that don't require touching a door like you see in modern airports these days. The less I have to touch in a public space the better.
I always found it rather strange that bacterial infections could spread so easily in a "sanitary" environment like a hospital. Bacteria can spread through the air, i.e. by someone sneezing and someone else inhaling it, but contact (touching surfaces containing the bacteria) is the most common method of transmission.
When the hospital staph only wash their hands 30% of the time when they interact with patients, it's no wonder that this crap can spread so easily.
It's ridiculous that something which should be a matter of habit has to be enforced with security cameras.
Indian workers are not watching your burger cook make your burger, and food poisoning at burger restaurants is more common than medical errors in hospitals.
But at least you accept its micromanaging horse shit, which is very much what I think it is.
That might well be better than a resentful, distracted matriarch forced to be away from her family.
I went through EMT training washing your hands, wearing gloves, wearing proper protective equipment was dam near physically beaten into me. Been on clinicals and the staff were the same way, whether I was the one shadowing them or just walking by and what I observed. Heck when I've been a patient I've used their hand sanitizer out of habit walking out of the room and had nurses look at me funny till I said it was out of habit due to EMT training in which I gotten a laugh. And that routinely happens when I end up visiting the doctor or end up going visiting someone I know in the hospital even if I am not there in a professional capacity, it's force of habit. It's the same way with everyone I know whether their EMT's, Paramedics, or Nurses.
So I can't help but think this was more of the cultural of that hospital or that particular area. Because the areas I've been in I have observed the exact opposite.
HEY! avg American IQ is WAY higher than 72! your a idiot.
Feeds from the video camera are transmitted to India, where workers there check to make sure staff are washing their hands.
Offshoring of hand sanitation with soap monitoring... The new little "bubble".
Wow, these guys are employing chaps across the world to do the job...
They handle(d) tech support so well that we're giving them grants to monitor safety! This isn't about $$, I assure you!
This solution is absolutely retarded. All you need to detect washing of hands is a cheap inertial reference sensor on a little tag worn on the upper body. A three-axis accelerometer and a three-axis angular velocity sensor is it. The change in posture and the sways propagating to the upper body are quite a distinctive signature, especially when you couple it with the signature of walking to the sink, and all the other things that are known to happen when you use a particular sink. You could probably tell which sink you're at. You don't need anyone in India to detect it. Modern signal processing deals with it just fine. Due to low sampling rates involved (100Hz is enough), you can do real time signal processing on a relatively low-power CPU, so that the battery life can be excellent. The system needs to check-in periodically via some RF technology, possibly simply Wi-Fi that's off most of the time, but comes up only to report significant events.
A successful API design takes a mixture of software design and pedagogy.
"Checklists deal with exactly the same phenomena and have produced great results in healthcare as well as exactly the same bogus complaints about lack of trust."
No, a checklist isn't the same as surveillance by an Indian across the world, and the complaint isn't bogus, it's basic people management 101.
It looks like a company has come up with this thing, hoping to market remote surveillance as a health and safety solution. Perhaps sell it to hospitals first, then fast food restaurants, then , ... who knows what their marketing plan is. But you learn basic human management 101 as a manager and this kind of thing has the opposite effect. You create a resentment, you undermine your own staff and you get sabotaging behavior.
It's counterproductive, you can hardly claim its a checklist, it isn't. It's just a bad idea being misold. It looks like one hospital manager was stupid enough, but there's always a few incompetent managers in any system.
That's life. Deal with it.
There's an attitude that leads to malpractice. My wife is a nurse, so I'm sympathetic about the pain of working holidays. However, the GP is right. On holidays you don't have elective surgery or regular appointments, but there's still the ER and patients in wards. There's no excuse for substandard care - ever. I'm sure my wife would agree as sloppy medical care infuriates her.
Not that such issues keep hospitals from constantly increasing the patient/nurse ratios. Why pay nurses to do silly things like care for patients when you can pay administrators 2x as much to work M-F and tell the nurses that there isn't enough money.
Let's consider alternative motivations for this implementation....
First off, creating a system that checks for this compliance and monitors/records every instance of compliance and non-compliance seems like a lucrative pot of HR gold. I wager that at least once, every employee will fail to register a required hand wash, or worst, the monitors in India will forget to record a hand wash when it did in fact happen. If the medical professionals are bound contractually to do so, perhaps any non-wash can be used as a breach of contract. This may allow 'liquidity' of the staff, as HR/admin can freely let any staff go without fear or obligation by citing the breach of contract.
Also consider where liability is placed when things go wrong. If the hospital has effectively found a way to mitigate liability and place this liability on the doctor/nurse, then this system will pay for itself many times over. Think about it; the hospital now has a record and can associate a doctor not washing hands and a patient getting sick and perhaps place the burden on the doctor. If this were to become the norm, the insurance these professionals carry may very well start to cost significantly more.
It is by no means "a major cause of death".
So tens of thousands of deaths each year (source CDC) is not a major cause of death? What do you consider a major cause of death? And hundreds of thousands of non-lethal infections. Even ignoring the pain and suffering component the financial cost is enormous.
Unless you are working on a surgical field where near absolute sterility is required, using the hand sanitizer after every patient contact and washing your hands after a few rounds of the hand sanitizer works as well as OCD hand washing.
The effectiveness of alcohol based hand sanitizers is debatable and they are known to be less effective than hand washing.
Then there are a number of other vectors for microbial transmission that this 1984-esque system doesn't address - stethoscopes and other instruments, pens, ties, lab coats.
All true but hand transmission is the biggest among them and we know that hand washing is an effective mitigation technique.
I scan read the article so feel free to point me to where it puts [someone unskilled] as judging [someone skilled]. i.e. The demoralizing situation created by this surveillance, which a classic management mistake. Because it seems to be, you could only find 'performance feedback', which could be something more professional like periodic self testing of hands for bacteria, or running through a checklist. (I don't have access to the papers cited).
"The good news is that micromanagement works:"
No, a typical checklist approach works and is not micromanagement and is constructive and empowering not destructive and dis-empowering. You really don't have to turn feedback into this 'management dickery'.
Why can't it be Americans watching!
Does this mean that they put the sinks outside the bathrooms?
Paul: Father... father, the sleeper has awakened! - Dune
Wish they had these where I work. One guy didn't even wash his hands after taking a dump. What the hell is that?! How can anyone want to walk around with shitty hands?
That has got to be the stupidest solution to the problem that anyone could imagine. Was this the result of some drunken contest?
As a survivor of childhood cancer, my wife has been in many, many hospitals. Most are very good with basic hand washing. Most have sanitizer dispensers near the door to the room, inside the room and in the hall. But one hospital in particular stands out in my memory as having employees that seldom washed their hands. It appeared to be a hospital-wide problem as they did not have sanitizer dispensers readily available. The employees seemed surprised and "hurt" when asked to wash their hands before touching the patient.
I'm pretty sure all it really takes is a directive from the higher-ups and a little bit of education. But hey, those kids in Bangalore have to do something I guess.
"The ferrets, they're every where I tell you!"
We should be tempering labor laws and industry regulation to ensure high quality staff, not pretending that the market is a cure-all.
Agreed.
I'd say its closer to a guild and that's part of why it works so well.
It's not working well when you suffer from an artificial shortage that the guild creates (in cahoots with the government, to which they give "recommendations"). People say the AMA is no longer the power house it was back when most doctors belonged to it and they paid Ronald Reagan to preach against the evils of anything that might lower their incomes (oops, I mean against the Evils of Socialized Medicine). To some extent that's true, but the retain enormous power in terms of "recommendations" about the number of med students, residency slots, and pay "recommendations" (one of the reasons for the ridiculous ratio between specialist and primary care physician incomes, and hence the shortage of primaries).
Bored?! Indian's won't get bored. India's avg IQ is 79.
If it's true, it shows that the real idiots are people who think that IQ scores mean much.
We should remove sinks from bathrooms. They should be outside of the bathroom. This solves several problems. First, you don't want to touch the bathroom door after you have washed your hands. Second, everyone will see who washes their hands and who doesn't because hand washing will be done in a public place. Third, this frees up space in the bathroom for extra facilities.
I always found it rather strange that bacterial infections could spread so easily in a "sanitary" environment like a hospital.
Being full of sick people, hospitals are not all that sanitary (not really a joke).
Disclosure: Recent med school graduate
1) Considering the time and personal sacrifice it takes to become an attending physician and make more than minimum wage, we're not all getting "extremely high pay". Frankly, considering the options available to most people who go to medical school in the US, the return on investment is pathetic.
2) The supply of physicians in the US is a complex problem (though the AMA is a bit retrograde on some issues). I'm not sure what "ruthless market competition" you want to expose the medical profession to, but if you want to get rid of licensure, I'm pretty sure the public would go nuts the first time there was a bad outcome from an unlicensed doc who got a foreign degree or no degree at all. If you meant more scope of care for mid-level providers then, yeah, I absolutely agree, especially for areas of practice with high volumes of common presentations where a physician can safely be called if there is an unusual variation.
The two biggest causes of the physician shortage in the US, though, are (a) reimbursement which favors procedures (this IS partly the AMA's fault, though has nothing to do with its guild-like properties and everything to do with how the US government chooses to set medicare reimbursement rates) and (b) geography. The geographic variation in physician availability is enormous. The real doctor shortage is the inability to find a doctor, let alone a sub-specialist in east bumblefuck. You could graduate a million extra doctors a year or let mid-levels expand their scope of practice as much as you like, but most of them are still going to want to live in cities or suburbs or areas with major medical centers. The areas with real access problems have a population density problem: There are literally so few people in these areas that they are hours from any medical care beyond some basic primary care and it just doesn't make sense for a given sub-specialist to practice in that area even though, collectively, the need for ANY specialty care is probably reasonable.
It's called seniority. Something you have to earn.
Hilariously topical malapropism.
So, it has come to this.
Have gnu, will travel.
I'm not sure if you are aware of this, but there actually are several options between the extremes of having holiday hospitals manned only by newbies and interns, and valuing workers with 20 years of experience enough to allow them perks like holidays off.
I always found it rather strange that bacterial infections could spread so easily in a "sanitary" environment like a hospital.
Also in a place where all viruses are killed, there are no bacteriophages to attack the viruses, unlike our mucous membranes.
+1 funee
WTF is wrong with everyone!!? Enough with the hiring of Indians to do everything! This is bullshit! Don't have them work off-shore OR bring them to the US, UK, etc, to work! If they're so smart, they can stay in their country, be self-sufficient, and have a thriving economy. Stop letting them pollute the rest of the world.
You're right about the night shifts, weekends and holidays being a real pain for nurses (and others) who work in a hospital, but many nurses (e.g. my wife) prefer the 12 hour shifts. It's a killer work day, but having 4 days/week off is nice. That's even more true if you have kids. At least sometimes you can see them, go to school events, etc.
Next thing you know, they'll be putting cameras at every urinal to make sure you hold your dick right.
because to the bean counters, administration is a revenue generator, as they are the ones bringing in the insurance and medicare money. Nurses are a cost center that needs to be reduced as much as possible.
for profit accounting should never enter the equation when lives are on the line.
Indeed. If you only have one highly-qualified nurse on-staff, you've got a big problem in the first place. You should have several, and they can rotate which holidays they work.
This is how it works in other industries that may require on-call staff during holidays. It's a solved problem.
If you're staffed entirely with n00bs who don't know how to do their jobs... good luck with that.
Check out my world simulator thingy.
All hospitals should encourage high level contamination and infection control procedures. All staff gloved/masked, etc. You'd stop 99.999% of the transmission of infection right there.
because to the bean counters, administration is a revenue generator, as they are the ones bringing in the insurance and medicare money
Not always, but the bean counters are part of administration. Do you expect them to recommend cuts? Funny how bean counters never worry about too many bean counters being an unnecessary cost. Or is that the executives not worrying about executives being an excessive cost center? Probably both. Then there are the schmucks who waste their time taking care of patients. What a bunch of loosers.
You clearly no nothing about the AMA, nor the major factors in health care costs.
The Kruger Dunning explains most post on
Except it's not.
Older nurse have to bend over backwards to keep their jobs, so the nurses with the most seniority, who also cost the most, end up working shit jobs becasue the hospital wants them to leave.
The Kruger Dunning explains most post on
If people spent less time in hospital because nobody was spreading disease around they wouldn't need so many staff to take care of everyone.
It's the bathroom monitoring being done from a country where folks wipe there asses with their hands. Outsourcing is ridiculous sometimes.
-- Jimtown Kelly
Have the bathroom door handle stain the hand with a soap-soluble dye.
Sure, that won't force the staff to wash their hands as often as they should .. but at least we'll know they washed their hands when they went to the bathroom.
Say OH! That's stupid. Here's a better idea. In each patient room or location where doctors and patients come together, put a sink and some soap, and a sign on the door.
The door's sign reads: ATTENTION PATIENTS: If your doctor doesn't wash his (or her) hands before dealing with you, you are waiving any right to sue if you get sick and die because your doctor's last patient had H.G.S.A., (HERPE-GONO-SYPHIL-AIDS,) SARS, EBOLA, H99N99 SUPERBIRDFLU, MEGA-RABIES, UBER-LEPROSY, AND FLAMING, RADIOACTIVE GENITAL WARTS, AND YOU DIDN'T. MAKE. SURE. HE/SHE. WASHED. HIS/HER. HANDS!
Then put a sign above the sink that reads "Doctors who do not wash hands before patient contact will NOT GET PAID."
Put the camera in the room, and when the patient walks out, if he/she says the doctor didn't wash, the tape gets reviewed If it's true, the Doctor is docked a day's pay for each time it happens. If it happens more than twice, fire him/her.
Nosocomial infections don't happen because hospitals and clinics are filled with magic badness-germs, they happen because clinicians are fucking careless and act as vectors for disease causing microbes and viruses.