John Weir – Healthcare Cleaning Professional

Come with me to a third grade classroom….. There is a nine-year-old kid sitting at his desk and all of a sudden, there is a puddle between his feet and the front of his pants are wet. He thinks his heart is going to stop because he cannot possibly imagine how this has happened. It’s never happened before, and he knows that when the boys find out he will never hear the end of it. When the girls find out, they’ll never speak to him again as long as he lives. The boy believes his heart is going to stop; he puts his head down and prays this prayer, "Dear God, this is an emergency! I need help now! Five minutes from now I’m dead meat." He looks up from his prayer and here comes the teacher with a look in her eyes that says he has been discovered.

As the teacher is walking toward him, a classmate named Susie is carrying a goldfish bowl that is filled with water. Susie trips in front of the teacher and inexplicably dumps the bowl of water in the boy’s lap. The boy pretends to be angry, but all the while is saying to himself, "Thank you, Lord! Thank you, Lord!" Now all of a sudden, instead of being the object of ridicule, the boy is the object of sympathy. The teacher rushes him downstairs and gives him gym shorts to put on while his pants dry out. All the other children are on their hands and knees cleaning up around his desk. The sympathy is wonderful. But as life would have it, the ridicule that should have been his has been transferred to someone else – Susie. She tries to help, but they tell her to get out. You’ve done enough, you klutz!"

Finally, at the end of the day, as they are waiting for the bus, the boy walks over to Susie and whispers, "You did that on purpose, didn’t you?" Susie whispers back, "I wet my pants once too."

May God help us see the opportunities that are always around us to do good. Remember…..Just going to church doesn’t make you a Christian any more than standing in your garage makes you a car.

Each and everyone one of us are going through tough times right now,  but God is getting ready to bless you in a way that only He can. Keep the  faith.

Just a few more days and another year is over. Goodbye 2009 and hello to a new 2010. This promises to be a great year as is is the start of a brand new decade. You still have time to work on your plan and goals for the new year. Get busy.

Three Skills That Improve Conversation

By Brian Tracy

One key to becoming a great conversationalist is to pause before replying. A short pause, of three to five seconds, is a very classy thing to do in a conversation. When you pause, you accomplish three goals simultaneously.

The Benefits of Pausing
First, you avoid running the risk of interrupting if the other person is just catching his or her breath before continuing. Second, you show the other person that you are giving careful consideration to his or her words by not jumping in with your own comments at the earliest opportunity. The third benefit of pausing is that you will actually hear the other person better. His or her words will soak into a deeper level of your mind and you will understand what he or she is saying with greater clarity. By pausing, you mark yourself as a brilliant conversationalist.

Ask Questions
Another way to become a great conversationalist is to question for clarification. Never assume that you understand what the person is saying or trying to say. Instead, ask, "How do you mean, exactly?"

This is the most powerful question I’ve ever learned for controlling a conversation. It is almost impossible not to answer. When you ask, "How do you mean?" the other person cannot stop himself or herself from answering more extensively. You can then follow up with other open-ended questions and keep the conversation rolling along.

Paraphrase the Speaker’s Words
The third way to become a great conversationalist is to paraphrase the speaker’s words in your own words. After you’ve nodded and smiled, you can then say, "Let me see if I’ve got this right. What you’re saying is . . ."

Demonstrate Attentiveness
By paraphrasing the speaker’s words, you demonstrate in no uncertain terms that you are genuinely paying attention and making every effort to understand his or her thoughts or feelings. And the wonderful thing is, when you practice effective listening, other people will begin to find you fascinating. They will want to be around you. They will feel relaxed and happy in your presence.

Listening Builds Trust
The reason why listening is such a powerful tool in developing the art and skill of conversation is because listening builds trust. The more you listen to another person, the more he or she trusts you and believes in you.

Listening also builds self-esteem. When you listen attentively to another person, his or her self-esteem will naturally increase.

Listening Develops Discipline
Finally, listening builds self-discipline in the listener. Because your mind can process words at 500-600 words per minute, and we can only talk at about 150 words per minute, it takes a real effort to keep your attention focused on another person?s words. If you do not practice self-discipline in conversation, your mind will wander in a hundred different directions. The more you work at paying close attention to what the other person is saying, the more self-disciplined you will become. In other words, by learning to listen well, you actually develop your own character and your own personality.

Action Exercises
Here are two things you can do immediately to put these ideas into action.

First, make a habit of pausing before replying in any conversation or discussion. You will be amazed at how powerful this technique really is.

Second, continually ask, "How do you mean?" in response to anything that is not perfectly clear. This gives you even more time to listen well.

Brian Tracy is the most listened to audio author on personal and business success in the world today.  His fast-moving talks and seminars on leadership, sales, managerial effectiveness and business strategy are loaded with powerful, proven ideas and strategies that people can immediately apply to get better results in every area.  For more information, please go to www.briantracy.com

ICE STORM TESTS KY HOSPITALS’ METTLE

by John Commins, HealthLeaders Media, March 11, 2009

If you weren’t living in Kentucky in the last week of January, the ice storm that crippled the Bluegrass State wasn’t much more than a lead item on CNN – something regrettable that happened to somebody else. You watched the coverage. You felt bad for them, but you probably forgot about it when CNN moves to the sports segment. After all, there is nothing more local than weather.

The news that wasn’t reported, however, was the widespread closure of rural hospitals, and hospitals running out of supplies and food, and leaving desperate, freezing patients to fend for themselves. That wasn’t reported because it didn’t happen. And that didn’t happen because of the remarkable efforts by some of those small, isolated community hospitals in the path of the storm.

Methodist Hospital, a 205-licensed bed community hospital in Henderson, on the Ohio River about 15 miles south of Evansville, Indiana, not only kept the lights on when a lot of the region was in the dark, but seved as a shelter for townspeople who’d lost power, needed a warm place to sleep and a hot meal, and had nowhere else to turn. The hospital lost land-line and most of its cellular telephone services and the icy roads cluttered with downed tree limbs limited access, but Methodist continued to provide care because of dedicated employees, a solid emergency management plan, and the help of suppliers.

Don Nauser, director of materials management at Methodist, says the hospital was ready when the storm hit due to disaster preparedness training that several dozen employees at the hospital had taken at the Emergency Management Institute in Anniston, Al. The hospital set up its command center that spelled out each operational task and the personnel assigned to that task.

“One of the things they teach you at Anniston is the first 72 hours you are on your own,” Nauser says. “The National Guard didn’t show up with MREs and cots until the Monday or Tuesday of the next week. They were affected as much as anybody.”

In the initial hours after the storm hit, when electric power for much of the area was cut by falling tree limbs and temperatures plunged, “everybody knew the place to go was the hospital because everyday assumed the hospital would have power,” he ways.

The biggest obstacles for Methodist were the ones they didn’t foresee. For example, when the land line went down, the local cellular telephone service that almost everyone at Methodist used also experienced weather-related problems and was all but inoperable. Nauser says they had to rely heavily on his personal cell phone, which was based in southeastern Missouri.

“Don’t assume that one vendor, in terms of cellular service, is going to be reliable,” Nauser says. “I would recommend having a backup. Ours here was completely off line.” He said his cellular service was one of the few links that Methodist had to a smaller, remote sister critical-access hospital in Morganfield, 30 miles away. Methodist also relied on sporadic Internet service, so employees could update the hospital on their availability, and the hospital could update employees about heir staffing needs.

Methodist was also able to use the Internet, satellite phones (“they work a lot better when there isn’t ice on the antenna,” Nauser says), and cellular phones to communicate with vendors who kept the hospital well-stocked, despite the nearly impassible roads. The main supply point in Paducah, KY had been hit hard by the ice storm. So, Methodist’s vendors which include U.S. Foods, Cardinal Health, and Premier Inc., went north of the storm’s wake and routed supplies through Indianapolis. “We did not miss a deliver,” he says. “It may have meant bringing trucks in at 10 at night or later, but the basic supplies that you need was almost uninterrupted.”
There was a huge – and unanticipated – demand for oxygen canisters for home-bound patients nearby. Methodist found itself cast into the role of chief oxygen supplier for the area after local durable medical equipment suppliers and retail pharmacies that normally sell oxygen told their patients they’d either run out of oxygen or couldn’t get the product to patients.

“They were telling people ‘go to the hospital because we can’t take care of you’,” Nauser says. “Every other problem paled in comparison to the demand for home oxygen. Smaller hospitals, know where your DME is coming from.” The ice storm and its fallout prompted Methodist to reconsider whether it will expand its role as oxygen supplier for the area in the future.

As they struggled during the week-long emergency to provide care and shelter, Methodist officials didn’t have much time to reflect on their reaction to the weather disaster. “You get to the point where you’re running on adrenaline,” Nauser says. But during that frenetic week, no patients were denied care or shelter and services continued in an orderly way. “When it was over I wandered back to the apartment and started to reflect that this worked smoothly,” Nauser says. “It wasn’t perfect. We learned lessons for the next time. But our level of preparedness helped prevent a whole lot of problems. It was as close to business as usual as we could get under the circumstances.”

We know that our primary purpose is cleaning. We train our staff to recognize dirt and soil in so many forms and to remove it. We educate, coach and celebrate our successes. We also know that good strategies for combating infection and cross contamination include things such as hand washing and personal protective equipment. In fact recent studies point more often to poor hand washing practices then the environment as the primary cause of hospital acquired infections.

We in Environmental Services understand the importance of hand washing as well as the importance of a clean environment. No matter how well hospital employees adhere to hand washing policies we simply cannot keep pathogens out. Without a top quality training program focused on cleaning and disinfecting the environment, infections will continue to be a problem; germs must be killed wherever they exist within the hospital environment.

I teach my staff to focus on cleaning. Our primary purpose is cleaning, and we never stop and say good enough. We clean and disinfect so that our surfaces not only look clean, they are free of contamination also. I work closely with our infection control department to track results and the partnership has helped to develop best practices that have proven very successful.

When you think about your role in healthcare, remember that without a healthy environment, patients will get sicker, and ultimately, go somewhere else for their healthcare. Support you facility with excellent cleaning, a team relationship with your infection control department as well as your staff. And don’t ever lose focus on cleaning for success.

Perhaps you sometimes think you don’t want the responsibility of running the ES department. If so you are not alone. When I transitioned from Supervisor to Manager some years ago it was like this. In the beginning, it was a challenge of transitioning from being an employee to running an organization, of being lonely and complete work / life distortion. However it did not take long to get organized and develop personal routines that helped me be calm enough to hear God’s instructions for success.

And when I say challenge, I mean I had to change my way of thinking about everything. Even though I had different life experiences to help, I sometimes had thoughts of, “what exactly did I get myself into”? That is when I had to remember we have a lot more help then we often realize. Adversity provides the resistance necessary to develop the strength to overcome great obstacles. This strength consists of self-confidence, perseverance, and, very importantly, self-knowledge.

As I have found many things becoming easier then other challenges arise and the responsibility and possibility of it all tries to paralyze me more than I want to admit. And I have to spend more time in prayer to get through it. Really, given the opportunity to change the world, would you take it? I believe those of us in this business think we would, but it is so very hard to look in the face of what you truly want and take it. It is very hard to fight the war of what really mattes and look past the fear to what possibilities lay ahead.

As the people in our departments change, we will find that many we have hopes for are not always stepping up. And those who do often think about stepping right back, because unless you are in the fight to make change, it is difficult to know how hard it really is. Keep encouraging them and believing in them so they will work with you to make your facility and department better.

This year will probably be one of your hardest. There will be days when you don’t want to strategize, or build relationships, or be so obsessed with seeing the ER floors looking awesome. Just remember you don’t always buy a thousand rolls of toilet paper at a time. Some days you have to be normal and just buy six rolls at the supermarket. While that is ok, remember “being normal” gets you fifth place, and you know you want to be in first, and all successful people take risks that normal people would not. But it’s the follow through that’s hard, the follow through that builds your character.

You will find that as you stay with it, you will be able to muster strength from somewhere you didn’t know you had. Every setback you encounter in life contains valuable information that, if you study it carefully, will eventually lead you to success. Without adversity, you would never develop wisdom, and without wisdom, success would be short lived indeed. When you make a mistake, say, “That’s good! I’ve gotten that out of the way. I will never do that again.” You will no doubt make other mistakes, but they won’t bother you nearly as much when you treat them as learning experiences.

During it all, remember that you are not alone. You have all your staff that together make up your team and you have all your peers here at ASHES to talk with and share ideas. Stay current with the changes that are happening and keep an open mind as the challenges come your way. Don’t be afraid to try something different, to think outside the box or to challenge the status quo. Keep your head up above the negativity and you will be ok. We all have within us the potential for greatness, and when your standard of performance is based upon being the best you can be-for yourself-you will never lose. You will only improve.

We have been doing patient rounding where we go see the patients and ask a few questions like, was your housekeeper friendly, was your room cleaned satisfactorily, is there anything we can do for you? We get good feedback and has helped our HCAHPS and Press Ganey scores.

Recently I’ve started using workers that have restrictions to the point where I can not work them, but they can walk, talk and write come in for ES Ambassador duty. I give them some scripting, a clipboard and the rounding questions and have them spend hours going to talk with patients. We talk about our goal of having their room always clean, how the survey works, and so on. I’ve had very positive feedback on this and it helps get the staff back to work with a better attitude.

I’ve increased our cross training and we all know how that helps. I’ve also moved staff more frequently to play to their strengths more than I have done in the past.

I put a large communication board in our common room. This happens to be our laundry and storeroom area where we check in and out the keys and pagers. During our standup meetings I share Press Ganey positive comments and other good comments and post them on our communication board. The increased focus on the score has helped I believe.

So far my HCAHPS score for the first quarter of 2009 is running 81%. This is a 10 point improvement over last years average, and higher over just November and December of last year.

What things have you all been doing to raise your scores and your staff satisfaction?

Good old fashoned hotel guest room cleaning tips. While not hospital work it is similiar and we have to appreciate the hard working staff that take care of us away from home. Enjoy!

HAYWARD, CA (March 4, 2009)—In its February 2009 newsletter, “Environments of Care News,” the Joint Commission, the main entity that accredits hospitals in the United States, has published an article titled “Preventing Infections in the MRI Suite: Magnetic Environment Poses Strong Challenges.”

This landmark article quotes Peter Rothschild, M.D., author of the groundbreaking paper “Preventing Infections in MRI: Best Practices” and founder of Patient Comfort Systems. The recommendations in Dr. Rothschild’s paper resulted from his close work with the infection control arm of the Joint Commission. Now, following the publication of Dr. Rothschild’s paper, the Joint Commission, realizing the critical importance and risk to the patient from the lack of infection control in MRIs, is alerting hospitals and imaging centers, in no uncertain terms, about the importance of infection control in MRI facilities.

Dr. Rothschild explains, “The Joint Commission is clearly concerned over the lack of infection control in the MRI suite. They will, in the future, closely examine this area, and properly train their inspectors to physically enter MRI rooms for a more definitive inspections. The areas under greatest scrutiny will be: 1) existence of an infection control policy; 2) how and when the MRI was cleaned; 3) who are the individuals performing this cleaning and what is their safety training; 4) examining all the table pads and positioners to see if they are torn or frayed. Inspection may even include a black light to reveal biological material embedded in the pads, on the table or within the MRI bore itself.”

“The Joint Commission clearly cannot assure the public that an accredited hospital is safe without thoroughly evaluating the MRI suite. The lack of even basic infection control, such as hand washing or cleaning between patients, is well known by technologists operating the MRI and radiologists reading the MRIs,” adds Dr. Rothschild, who also has published an 11-step infection control policy designed for the MRI center. As Dr. Rothschild explains, “An MRI is a very complex and dangerous area to clean. It is unreasonable to think it can be cleaned safely and effectively by untrained personnel.”

Dr. Richard Nolan, M.D., a well-respected orthopedic surgeon in the San Francisco Bay Area, states, “The MRIs I have seen in the hospitals and especially outpatient facilities have basically no effective infection control. It is all adhoc by whomever the technologist is running the MRI at the time. I have been disgusted by the total lack of cleanliness in these facilities. Rarely do I ever see a technologist even wash his/her hands between patients much less make sure that the pads are not torn and that they are cleaned properly between patients. It has always been unclear to me how a hospital could pass a Joint Commission inspection year in and year out with such a lack of infection control and in clear violation of the Center for Disease Control guidelines. Clearly the Joint Commission inspectors in the past have not looked in the MRI suite. This is unfortunate since my patients think that if a hospital is certified by the Joint Commission, the MRI is clean and safe. In the past there has been nothing farther from the truth. This is why I congratulate the Joint Commission for taking on this important health issue.”

The Joint Commission has made it clear that they are following the CDC guidelines on infection control. These guidelines specifically state that a clean sheet is not a barrier to infectious agents. However, this is usually the only thing used by imaging centers to protect their patients. The CDC guidelines also make clear that the pads on the table as well as the coils must be cleaned between patients, not merely covered with a sheet. Most importantly, the CDC states that if table positioners or pads are torn or frayed they must be replaced. Therefore, the common practice of simply placing a clean sheet over torn, contaminated pads and covering up the smell with air freshener is a clear breach of basic infection control. Another common violation of CDC standards at outpatient MRI centers is the incredibly dangerous practice of having employees take contaminated laundry home to wash in their own household washing machines in order to save money. Not only can this further the spread of infectious agents throughout the community, but since their washing machines often lack any special sanitizing capabilities, these employees risk contaminating their own family’s clothing and thus even further spreading diseases.

“This is one of the many practices that show the total lack of understanding of infection control at MRI centers, putting not only their patients at risk but also their employees, their families and ultimately the entire community. These are just a few of the reasons the Joint Commission is so concerned about lack of infection control in these MRI facilities,” explains Dr Rothschild.

Antonio Bayon, President of MagnaWand, echoes Dr. Rothschild’s concerns while focusing on the cleanliness of the MRI bore itself. “I have been involved in the MRI business for more than 20 years, half of those years as an MRI service engineer. During my years as a service engineer, I saw all kinds of biological contaminants inside the bore of the magnet. It was common to see blood, urine, and other patient’s fluids in the tube, where the patient is placed for their MRI. I have even seen vomit dripping down the insides of the bore. I can assure you that this critical area where there is very close patient contact is not being cleaned. In the only study ever to look for the superbug MRSA in an MRI, it was found colonized in the bore of the MRI.”

Dr. Rothschild adds, “I am most disappointed by the total lack of concern by the radiology community to address this clear and present danger to our patients. I hope that the Joint Commission’s new direction will encourage administrators as well as risk management departments to take this issue seriously and adopt procedures designed to protect the patients. Until this is uniformly applied, the patients and referring doctors are basically on their own to determine if an MRI center is safe. This is most concerning for patients who are immunosuppressed or have a poorly developed immune system as their risk of a Superbug infection is often life threatening.”

Louise Kuhny, RN, Senior Associate Director of Standards and Interpretation Group at the Joint Commission, has stated in the article that the Joint Commission’s infection prevention standard underscores the need for a clean MRI suite, and that every accredited organization must have a specialized infection prevention plan. She further states the need for procedures concerning the proper removal of body fluids and disinfection of contaminated areas between patients. Most importantly, Ms. Kuhny discusses that the Joint Commission inspectors expect to see compliance such as mandatory hand washing by providers between every patients.

Louise Kuhny, RN, assures that “the Joint Commission surveys include all areas of an accredited facility in this survey activity including the MRI suite.”

As emphasized by Dr. Nolan, “A hospital’s overall infection control policy can only be as strong as its weakest link. This weakest link has clearly been demonstrated to be in the MRI suite. Immediate urgent attention by the risk management department and the administration of these hospitals and clinics is needed to address this serious public health risk. The 11-step procedure for infection control in MRI, developed with the help of infection control experts at the Joint Commission, is an important first step for hospitals and imaging centers to come into compliance with infection control standards that are used throughout the health care industry.”