Slashdot Mirror
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."
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.
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
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 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.
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
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
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 !
you're more likely to be ill leaving the hospital than entering it
A quick Google suggests you're being dishonest. So, yeah, citation needed.
Why are you lying? If you have to lie to prove your point (which is sad because you were on the right side) then your point isn't worth making. If you have to resort to lies then you shouldn't do it online where people have the capacity to verify your statements simply by highlighting, right clicking, and selecting search Google. You can't browbeat people into cowing online no matter what your wife and kids tolerate.
"So long and thanks for all the fish."
According to this, "it has been estimated that hospitalacquired infections are responsible for 80,000 deaths in the United States and 5,000 deaths in the United Kingdom." "Compliance rates were ... lower among physicians (32%)." So only 32% of doctors are washing their hands, killing 80,000 people per year. I will let the reader decide whether they want to compare this to the deaths caused by automobiles (32,367) or handguns (31,672), but apparently keeping hands clean in hospitals is a serious public health problem, and one that, of all people, hospital administrators, doctors and nurses should all be doing everything they can to fix it.
The good news is that micromanagement works: "The majority of the time, the situations that were associated with a higher compliance rate were those having to do with dirty tasks, the introduction of alcoholbased hand rub or gel, performance feedback, and accessibility of materials."
This isn't about monitoring bathroom breaks, it is about monitoring basic competence to do your job. A patient is supposed to end a hospital visit healthier than they started, and if health care professionals are doing things that make that goal more difficult then they are failing at their job. It's not the same as, say, monitoring the number of lines of code that a developer writes (where there is, at best, a tenuous relationship between the measured value and the quality of software - and probably none at all), it is a well-documented and serious problem that kills people. It's more like measuring whether a developer leaves his workstation turned off all day. Washing hands regularly is a necessary though not sufficient condition to make people healthy in a hospital, and if constant monitoring is required to get more than 1/3 of doctors to do it, then so be it.