Good management means understanding how teams operate. It’s worth remembering that teams usually follow a certain pattern of development. It’s important to encourage and support people through this process, so that you can help your team become fully effective as quickly as possible.

When forming teams, managers must create a balance so that there’s a diverse set of skills, personalities, and perspectives. You may think it’s easier to manage a group of people who are likely to get along, but truly effective teams invite many viewpoints and use their differences to be creative and innovative.

Here, your task is to develop the skills needed to steer those differences in a positive direction. This is why introducing a team charter and knowing how to resolve team conflict are so useful for managing your team effectively. Finding great new team members, and developing the skills needed for your team’s success is another important part of team formation.

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The process of physical cleaning of environmental surfaces using detergent (soap), water, and friction is the critical step required prior to surface disinfection. The combination of the cleaning and disinfection processes is designed to remove and kill vegetative microorganisms on surfaces. Disinfection will not be effective in the presence of dirt, blood, or other bio burden. The  goal of the cleaning step is to remove bio burden and with it, the majority of pathogens. Disinfection is designed to be a synergistic and somewhat redundant step to ensure comprehensive removal/kill of pathogens on surfaces.

The CDC’s Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008, states that, “noncritical surfaces (e.g., dialysis bed or chair, countertops, external surfaces of dialysis machines) should be disinfected with an EPA-registered disinfectant unless the item is visibly contaminated with blood. In that case, an EPA registered tuberculocidal agent with specific label claims for HBV and HIV should be used.”1 the commonly used disinfectant for blood contaminated environmental surfaces is a 1:100 dilution of bleach (500–600 parts per million [ppm] free chlorine).

The environmental surfaces in HD settings at highest risk of transmitting germs are described using different terms. From the perspective of the patient, the term “patient zone” is used to refer to the surfaces which the patient can touch, or can touch the patient, including the chair, armrests, bedside table top/counter, and drawer/cupboard handles. From the HCW or dialysis staff perspective, the term “high touch surfaces” is used to describe surfaces which are frequently touched by HCWs. These include the same surfaces in the patient zone in addition to others such as the exterior surfaces of the HD machine, computer screens, and keyboards. Cleaning and disinfection of these surfaces (patient zone/high touch surfaces) should be performed between all patient treatments, no matter what the patient diagnosis is, in order to prevent spread of environmentally transmitted pathogens including MDROs (e.g., MRSA, VRE, C. difficile) and bloodborne pathogens (e.g., HBV, HCV). Of note, microorganisms can live for varying periods of time in the environment. MRSA has been documented as viable at 38 weeks on external sterile packaging and VRE at 6 months on a wheelchair. HBV can survive for 7 days in dried blood.

There are certain products and principles which are recommended in order to optimize environmental cleaning in healthcare settings, including HD facilities. These include the following tasks which are typically performed by the dialysis nurse or technician.

• Store cleaner/disinfectant separately from skin antiseptics/patient supplies (separate shelves and below patient supplies to avoid potential contamination).

• Perform hand hygiene before and after cleaning the patient station.

• Don gloves when using cleaner/disinfectants.

• Use one set of cleaning cloths or disposable germicidal wipes for each patient station.

• Use microfiber cloths and mops if possible (more effective cleaning products than regular cotton cleaning cloths).

• Clean all frequently touched or “high touch” surfaces in the “patient zone” between patient treatments (chair, armrests, counters, drawer/cupboard handles, exterior surface of the HD machine)—please note that some of these high touch surfaces may be right outside the patient zone (e.g., computer stations), and must also be cleaned between patient treatments.

• Clean the top of an object first and work down to avoid soiling surfaces just cleaned.

• If using cleaning cloths instead of disposable germicidal wipes:

• When using a disinfectant cleaner, wet the surface, use friction to clean, and allow to air dry.

• Fold the cleaning cloth in a series of squares to provide a number of potential cleaning surfaces. A wadded cloth does not clean efficiently.

• Replace cloth as needed. More than one cloth may be required for a patient station.

• Never use the same cleaning cloth for more than one patient unit.

• Never re-dip used cloth into clean disinfectant solution.

Additional cleaning functions, typically performed by housekeeping staff in HD facilities, should include:

• At the end of the day:

• Wet mop the floor

• Clean patient/staff bathrooms and restock paper products/hand hygiene supplies

• Check and refill all hand hygiene product dispensers in nursing stations and at patient stations (soap, paper towels, lotion, alcohol-based hand sanitizer)

• On a routine basis, walls and high dusting should be performed.

Multi Drug Resistant Organisms Cleaning and Disinfection

Many healthcare workers believe the environment of patients with MDROs require special cleaning. Healthcare workers in HD facilities should clean the environment of the MDRO patient as they would for any patient, as many more patients than are known are colonized/infected with an MDRO. Cleaning involves the use of friction on environmental surfaces to physically remove the soil and germs. The wet contact time of the germicide on the surface helps kill or inactivate any remaining microorganisms. The exception is C. difficile, which requires removal by friction and is not inactivated by any surface disinfectant except bleach.

EVS is a proud and honorable profession and as such it must always insist on doing the best and taking the extra steps to ensure that everyone and everything associated with it is held to the highest standards and goals.  If our professionals do not do so, we will see other disciplines encroaching upon and annexing what is currently EVS. 

I would suggest that you look for the following on-line: State Operations Manual, Appendix A – Survey Protocol, Regulations, and Interpretive Guidelines for Hospitals or go to this link to download a PDF document that you may find invaluable:

www.hcmarketplace.com/supplemental/8987_browse.pdf

For assistance in reasoning out the excluding of the rooms in question, I refer everyone to the following.  They are two typical CMS Guidelines cited.  I’ve also provided an OSHA Website that might interest you.

Interpretive Guidelines §482.41(c)(2) – Facilities, supplies, and equipment must be maintained to ensure an acceptable level of safety and quality. Interpretive Guidelines §482.42 Condition of Participation: Infection Control.

http://www.osha.gov/SLTC/etools/hospital/housekeeping/housekeeping.html#ContaminatedWorkEnvironments

Here are some of the steps I said would be important in reviewing their existing housekeeping operations or developing new outsourcing initiatives.

Two key phases of review include:

Analysis

• Interviews with administration/housekeeping/staff
• Facility inspection
• FTE analysis
• Existing support contracts
• Departmental policies & procedures
• Review of housekeeping requirements
• Budget review
• Review of supplies & equipment

Scope

• Physical auditing process
• FTE determination
• Training requirements
• Contractor performance expectations
• Quantifiable & measurable performance requirements
• Quality control processes
• Benchmarking
• Selection of qualified contractors and contract type
• Work loading

These are first steps, and make a great start. Contact me if you want to discuss this further.

Don’t start itching, and then check underneath your bed! You see it seems that bedbugs, also known as Cimex Lectularius are showing up in many places.

The bloodsucking bugs were virtually eradicated in the United States in the 1950s. But they are now showing up practically everywhere, nursing homes, jails, apartment buildings, dormitories, even hospitals. There has been a 500% increase in the last few years!

Experts blame the resurgence on increased international travel, immigration, changes in pest-control practices, and the bugs’ growing resistance to insecticides.

Bedbugs can live for a year without a blood meal, but once they start biting their victims may be plagued with multiple bites each night.

The EPA has made some information available to the general population that should be of interest to healthcare professionals.

http://cfpub.epa.gov/oppref/bedbug/

http://www.epa.gov/bedbugs/

Here is a link to the CDC as well:

http://www.cdc.gov/nceh/ehs/Publications/Bed_Bugs_CDC-EPA_Statement.htm

I hope this is of benefit to all of you with problems or concerns.  Please pass this information along to your staff, your Infection Preventionist, Facilities department, and anyone that can be of assistance in addressing the infestations.

What good is it to terminally clean a room including wiping down all of the People Contact Points/Touch Points to rid them of potential microbes that cause HAIs and yet leave curtains that have been touched countless times by contaminated hands?

Curtains should be changed at each and every terminal cleaning – period.  Is it done? No.  Is there documentation that curtains act as vectors for microbes? Yes. You can download the report below.

Infection Control and Hospital Epidemiology November 2008, Vol. 29, No 11; 1074-1076

I wrote some general cleaning procedures back here and several people thanked me and asked for more. So I want to take some time and give you some more general and some specific cleaning procedures, along with some important definitions.

I have two ways to explain what I feel clean is. First, the absence of removable soil. Sometimes that means the object may be clean but still look bad, such as a wall that needs paint, or a desk that is scratched. It might also be that there is a stain, something that is not removable so the object does not really look clean. Second, I like to say that it will look brand new, or as close to that as possible.

In healthcare cleaning, we go beyond the look of something. It is the visible dirt that makes us unhappy, but it is the invisible “dirt” that makes us sick. We clean surfaces that may already look clean to the naked eye but under a microscope it could be crawling with bacteria.

So what is cleaning?

cleaning present participle of clean (Verb)

1. Make (something or someone) free of dirt, marks, or mess, esp. by washing, wiping, or brushing: "chair covers should be easy to clean"; "he expected other people to clean up after him"; "Anne will help with the cleaning".

What is green cleaning?

Green cleaning can be defined as “effective cleaning that protects health without harming the environment.”

The federal government has defined “green” and “environmentally preferred purchasing” as “…products and services that have a lesser or reduced effect on human health and the environment when compared with competing products and services that serve the same purpose.” — Executive Order 13101 which can be seen at www.ofee.gov/eo/13101.htm.

Both definitions focus on the impact cleaning has on the health of people as well as the impact it has on the environment. Both definitions also describe a goal of striving to make sure cleaning has as positive an impact on human health and the environment as possible. ⁽¹⁾

What is Terminal Cleaning?

Terminal cleaning methods vary, but usually include removing all detachable objects in the room, cleaning lighting and air duct surfaces in the ceiling, and cleaning everything downward to the floor. Items removed from the room are disinfected or sanitized before being returned to the room. Terminal cleaning of patient rooms should include the following steps: ⁽²⁾ 

• Using an EPA-approved, hospital-grade disinfectant, the following items should be cleaned:

> Top, front and sides of the bed’s headboard, mattress, bedframe, foot board and side rails, and between side rails

> TV remote

> Nurse-call device and cord

> All high-touch areas in the room including tabletops, bedside tabletop and inner drawer, phone and cradle, armchairs, door and cabinet handles, light switches, closet handles, etc.

• In the bathroom, start with the highest surface and clean the toilet last; clean the sink and counter area, including sink fixtures, and if there is a shower, the support bars and shower fixtures and surfaces

• Privacy curtains should be removed, placed in a plastic bag in the room and double bagged into a laundry bag with the assistance of another member of the ES staff standing at the door outside the room. The person outside the door should wear gloves. After completing the task this person should remove gloves, wash hands with an antimicrobial soap and water or apply an alcohol rub to their hands.

• Cleaning of window curtains, ceiling or walls is not necessary unless visibly soiled.

• Following patient discharge, clinical equipment must be cleaned and disinfected, moved to the door of the room for removal to central supply or to the sterile processing department.

• Following the terminal cleaning of a patient room, gloves should be removed so as to avoid touching the outside of the gloves. Hands should be washed with an antimicrobial soap and water or an alcohol rub applied to the hands prior to donning a new set of gloves.

Best Tip for cleaning:

Use microfiber towels and mops. This is the single most effective change you can make. Microfiber is a scientific discovery that is the foundation for a greener, safer, healthier environment. Microfiber is able to accumulate and absorb more particles of dirt and bacteria than any other fabric known. It can absorb up to 7 times its weight in dirt or liquid. Microfiber is a lint free, non-abrasive, and hypoallergenic product that allows you to clean without the use of chemicals. Unlike ordinary cotton towels that move, or push, the dirt and dust from one point to another, Microfiber actually gets underneath the dirt and lifts it from the surface. It then stores the dirt particles in the towel, until it is washed. Microfiber dust cloths are safe on all surfaces.

Using a traditional cotton loop mop for wet mopping in hospitals has been standard operating procedure in floor cleaning for healthcare facilities for decades. Recently, the healthcare industry has begun to look long and hard at evaluating a different method for cleaning hard surface floors within healthcare facilities with the hope of reducing chemical use, water use and increasing employee and patient health as well as improving overall cleanliness on site. ⁽³⁾

Microfiber mops are densely constructed polyester and nylon fibers able to hold 6 times their weight in water. Because the fibers are positively charged, it attracts and picks up dust (which is negatively charged), and these microfibers are able to penetrate the microscopic surface pores of any material.

Using the traditional cotton loop mop, it was required that the mop head and water be changed every two or three rooms to reduce the risk of cross contamination. This meant dumping gallons of water and chemical down the drain along with the hardship on employees of lifting the heavy bucket to do so.

Using the microfiber mops, the risk of cross contamination is reduced greatly in that you use one mop per room. With the microfiber system, 20 rooms can be cleaned using 1 and ½ gallon of water and 1 and ½ ounces of chemical.

Use of microfiber in hospitals and other organizations has been endorsed by:

• The Environmental Protection Agency (EPA)
• The American Hospital Association
• The American Nurses Association
• Association for Professionals in Infection Control and Epidemiology (APIC)

Last but not least, use some Elbow Grease                                                               

Elbow grease is an idiom for working hard at manual labor, as in "You need to use some elbow grease." It is a humorous reflection of the fact that some tasks can only be achieved by hard effort and human energy, contrasting with the idea that there should be some special oil, tool or chemical product to make the job easier. Even with green chemicals and microfiber, cleaning takes effort. You can’t swish a towel around and expect a surface to be clean. You need to put some effort in and scrub. This is one area where there are no shortcuts. Can’t get those minerals off the toilet?, scrub. Shower walls have a film? scrub it.

References:

1 http://www.waxie.com/what_is_green_cleaning_.html

2 “Practice Guidance for Healthcare Environmental Cleaning” from the American Society for Healthcare Environmental Services (ASHES).

3 American Journal of Infection Control Volume 35, Issue 9, November 2007, Pages 569 – 573 William A. Rutala PhD, MPH, Maria F. Gergen MT (ASCP) and David J. Weber MD, MPH

Download the Environmental-Cleaning-Checklist-10-6-2010 from this link or go directly to the CDC site.

In the great work presented in Options for Evaluating Environmental Cleaning, December 2010 by Alice Guh, MD, MPH and Philip Carling, MD, objective monitoring of environmental surfaces was studied and presented as a necessary component of training. In view of the evidence that transmission of many healthcare acquired pathogens (HAPs) is related to contamination of near-patient surfaces and equipment, all hospitals are encouraged to develop programs to optimize the thoroughness of high touch surface cleaning as part of terminal room cleaning at the time of discharge or transfer of patients. A two level approach to this is presented and quite well discussed.

For now please draw your attention to the 8 locations above. The importance of targeted cleaning to these surfaces must be taught to your staff and reinforced on a regular basis. While many of our staff have an excellent understanding of the basic policies and procedures involved in terminal room cleaning, most will benefit from focused educational interventions related to our evolving understanding of the role of the environment in healthcare-associated pathogen (HAP) transmission. Specific targeted cleaning will not only reduce HAI’s it will greatly increase the awareness level of your staff.

The clinical measures will account for 70% of a hospital’s VBP score and the HCAHPS survey for 30%. For FY 2014, CMS will add the heart attack, heart failure and pneumonia mortality measures to the VBP program, as well as eight measures of hospital-acquired conditions and two composite patient safety and inpatient quality indicators developed by the Agency for Healthcare Research and Quality. The VBP program will apply to all acute-care prospective payment system hospitals with certain exceptions. For example, for the clinical process measures, CMS will exclude from hospitals’ scores any measures for which they report fewer than 10 cases and will exclude from the VBP program any hospitals for which fewer than four of the 12 proposed clinical process measures apply. CMS will also exclude from the VBP program any hospital that reports fewer than 100 HCAHPS surveys during the performance period.

For the FY 2013 incentive payments, CMS proposes that it will use data associated with hospital discharges from the third and fourth quarters of 2011 and the first quarter of FY 2012, as the “performance period” for the proposed clinical process of care and HCAHPS measures. So starting July 1, 2011 and running to March 31, 2012, our scores for “Room and restroom always clean” will be very, very important. All your hard work improving your scores will now be validated.

A hospital’s performance on each measure during the performance period will be compared with a “baseline period” from July 1, 2009 to March 31, 2010. Whether the hospital receives a value-based incentive payment, and the amount of such payment, will be based on either how well the hospital performs on the specified quality measures during the performance period or how much the hospital’s performance improves on the quality measures from its performance during the baseline period. The higher a hospital’s achievement or improvement during the performance period, the higher the hospital’s value-based incentive payment.

Do you know what your HCAHPS scores were July 1, 2009 to March 31, 2010? If you have been tracking and working on your performance good for you. If not, well, I’m sure you will be now. You should already have a spreadsheet setup for doing your own comparison and tracking.

In upcoming posts I will be writing about steps you can take to improve your scores and staff performance. Go HCAHPS!

Clostridium difficile is a spore-forming, gram-positive anaerobic bacillus that produces two exotoxins: toxin A and toxin B. It is a common cause of antibiotic-associated diarrhea (AAD). It accounts for 15-25% of all episodes of AAD.

Clostridium difficile is a bacterium that may develop due to the prolonged use of antibiotics during healthcare treatment. Clostridium difficile infections cause diarrhea and more serious intestinal conditions such as colitis. The CDC provides guidelines and tools to the healthcare community to help end clostridium difficile infections and resources to help the public understand these infections and take measures to safeguard their own health when possible.

C. difficile is an anaerobic, gram-positive bacterium. Normally fastidious in its vegetative state, it is capable of sporulating when environmental conditions no longer support its continued growth. The capacity to form spores enables the organism to persist in the environment (e.g., in soil and on dry surfaces) for extended periods of time. Environmental contamination by this microorganism is well known, especially in places where fecal contamination may occur. The environment (especially housekeeping surfaces) rarely serves as a direct source of infection for patients. However, direct exposure to contaminated patient-care items (e.g., rectal thermometers) and high-touch surfaces in patients’ bathrooms (e.g., light switches) have been implicated as sources of infection.

How is Clostridium difficile transmitted?

Clostridium difficile is shed in feces. Any surface, device, or material (e.g., commodes, bathing tubs, and electronic rectal thermometers) that becomes contaminated with feces may serve as a reservoir for the Clostridium difficile spores. Clostridium difficile spores are transferred to patients mainly via the hands of healthcare personnel who have touched a contaminated surface or item.

Transfer of the pathogen to the patient via the hands of health-care workers is thought to be the most likely mechanism of exposure. Standard isolation techniques intended to minimize enteric contamination of patients, health-care–workers’ hands, patient-care items, and environmental surfaces have been published. Hand washing remains the most effective means of reducing hand contamination. Proper use of gloves is an ancillary measure that helps to further minimize transfer of these pathogens from one surface to another.

What can I use to clean and disinfect surfaces and devices to help control Clostridium difficile?

Surfaces should be kept clean, and body substance spills should be managed promptly as outlined in CDC’s "Guidelines for Environmental Infection Control in Health-Care Facilities." [PDF 1.4 MB] Routine cleaning should be performed prior to disinfection. EPA-registered disinfectants with a sporicidal claim have been used with success for environmental surface disinfection in those patient-care areas where surveillance and epidemiology indicate ongoing transmission of Clostridium difficile. It is important to distinguish the need for a disinfectant with a sporicidal claim. Currently only specific bleach containing products have this registration. Bleach harms surfaces and is hazardous to the user. Normally, HAI’s can often be controlled with good cleaning practices and a non bleach disinfectant.

The recommended approach to environmental infection control with respect to C. difficile is meticulous cleaning followed by disinfection using hypochlorite-based germicides as appropriate. I recommend using microfiber towels and an accelerated hydrogen peroxide based disinfectant. There are now a few products with a C.difficile claim. One I have tried is Dispatch wipes. I found the odor to be acceptable for most of my staff but the film left after using is a significant and required a second cleaning to remove it for an acceptable appearance.

Want to start making more progress toward your goals or business targets?  If you do, here is a simple process, which is guaranteed to work for you so long as you use it.  It’s based on a weekly, 3 step process of; reviewing, learning and taking action.  Although the focus is on weekly progress, by making each week an improvement on the previous week, you also make each month and year better too.

Here is how it works:

1. Do a review of last week

Start off by doing a review of last week.  Here are a few questions to ask yourself:

• Who did I connect with?
• What measurable progress did I make?
• What went less well for me?
• What ate into my time, with little return?
• Where did my best results come from?

Write your answers down and get them ready for the next step.

2. What did I learn from last week?

Reviewing your answers from the previous step, what lessons are there?

The way you invest your time, is directly linked to your success or otherwise.  This is why it’s important for you to identify the activities that sucked your time up, without providing you with some kind of measurable progress.  Equally, you need to determine what activities were most profitable for you.

Write down as many lessons from last week as you can.  Look for the gold dust and also the dross.

3. What will I do to make this week better?

If a commercial activity was not working for you last week, you need to either fix it or remove it from your work-flow.  Many small business owners repeat things that don’t work, purely because they are comfortable with them.  They hope that their results will “just get better”, yet as Einstein assured us:

Insanity is doing the same thing over and over, and expecting different results!

The week ahead can either be a chance for you to get a week better or a chance for you to relive the same frustrations again.  The reason most people simply get a year older each year, rather than a year better each year, is that they allow themselves to get into an unproductive rut.  They work hard, but mistake movement, for progress.

This final step is what separates the winners from the masses of frustrated business owners who make little if any progress.  Great intentions are not enough.  The world is full of people with great intentions, yet very few people action those great intentions.  You need to be smarter than that, if you want to make real, measurable progress.

Identify the changes you need to make and then motivate yourself to take the action required.  This is the cornerstone of all progress and the end to a life of frustration.

“It’s not the size of the dog in the fight, it’s the size of the fight
in the dog.” – Mark Twain.

That Mark Twain saying, may seem kind of cliché… but think of it that
you are hearing it for the first time; It’s pretty powerful.

The quality of ‘fierceness’ (the fight) is really not what comes to my
mind when I hear that saying — For me it’s the ‘burning desire’ and
‘persistence’ of the small dog that impress me the most.

I hear regularly that we have our staff reduced, budgets cut and
additional space added…

…yes many are having tough times now. Things are not working out as
they planned, and some don’t feel they can achieve success.

People throw the word ‘success’ around as if it defines a certain
level of achievement. A certain HCAHPS score, Press Ganey rating, NRC
Picker Score.
Success can be small improvements and victories that you already make everyday.

For example…

If you are updating routines, writing down your your target results
and desired outcomes is your first step. A small but important step.

As you sit down to craft that new routine, you feel excited about the
possibilities of success.

You gather the excitement of this simple activity and you begin to
feel more positive.

When you finish updating your job routines and assignments, you feel
elated enough — one more task completed — but don’t feel successful…

…Why? Most often, success to us is that 99%tile, perfect score, no
complaints and other stuff.

But, if we think about success in ‘small increments’, more like little
victories — it’s less overwhelming, and it’s more fun that way.

Consider every small improvement that you make in your work a huge
victory. Do more of these small improvements and be persistent.

Persistence is key to feeling successful.

There are many qualities that help us in our work, but if I were to
pick one personal quality that stands out, it would have to be
‘Persistence’.

To your Persistent Success,

John

Far too many people spend more time planning their weekends than their lives. Then they suddenly realize that life has passed them by and they weren’t even aware it was happening. When you intently study what you most desire in life, you begin to focus your mind and concentrate your energy upon that which you wish to achieve. One of the great advantages of having a definite goal for your life is that it helps you prioritize your activities. When your major purpose is clear in your mind, it is unnecessary to analyze each individual situation. You know automatically whether your actions will move you toward your goal or away from it. You can then use all of your resources-time, money, and energy-to best advantage.

If you look around you will find there are three kinds of people, or
better put, three ways to look at “failure”. If you know me, then you
know I don’t like the word failure in the first place. I think people
need to be in the mindset that failure is just another word for try
again. What I recently learned is “try again” does nothing if you
don’t change your strategy. More on that in a moment.

The first way to look at failure is to say “I failed because I’m not
good enough” or “I failed because it was too difficult”. Then start
making excuses, blame anyone but yourself, complain and give up. These
people say it did not work, so lets forget about it. Then they go on
to something else. This makes me wonder why they try anything in the
first place. Reminds me of the guy I mentioned in a previous post
who never wants to try anything new. You can’t fail if you don’t try to do anything.

The second way to look at failure is to say you need to try harder. In
this group, you don’t think you fail because you are not good enough,
it is because you did not try hard enough. They try harder next time,
still don’t get results, so the try even harder the next time. They
try again and still don’t get the results they want, so what do they
do? You guessed it. Now eventually, if they target small goals, they
will hit them. However if they set high goals, it is rare that they
will reach those goals. They will improve by taking so much action but
they won’t hit the goals they really want. They never live the kind of
life they want. The reason is they keep on taking action but they
don’t change their strategy. In other words, if you keep on doing the
things you are doing today, you will reap the same results. After a
while, these people get really frustrated. I have seen many sales
people and network marketers fall into this category, and you will see
people in every business in this category. They work harder, see more
people, but more or less they stay in their comfort zone of doing the
same things the same old way. After a while they say “I’ve tried so
hard, I’ve tried everything” and they get cynical. They look at people
who have experienced success and think they are just lucky people.

So what is the answer? The third group of people respond to failure
very differently. In fact, they don’t even see failure as failure.
They say, “I did not fail. I just got feedback that I used the wrong
strategy.” By looking at not reaching their goals as just a sign to
change direction, to try something new, to change their strategy they
do not feel bad. They do not get demoralized, rejected, or depressed.
They still feel empowered, they still feel motivated. Without
realizing it, they use what is called reflective intelligence. They
are able to notice what went wrong with the strategy and they have the
ability to change their behavior and do whatever it takes to take
action again and again until they get the result they want.

So I hope you can take these examples of three ways to look at
“failure”, and make an effort to change your thinking. Decide that if
at first you don’t succeed, change your strategy and try again. Don’t
be defeated, don’t think you are not lucky, and by all means, don’t
just simply try again using the same methods that did not work in the
first place.