I think we are all familiar with the visual illustration of a devious little devil and innocent angel perched upon a person’s shoulders representing the opposite positions or choices that person can make related to a certain situation. What better way to represent the difficulty between choosing right vs. wrong; good vs. evil; or hard vs. easy than having characters that are the embodiment of right (Angel) and wrong (Devil) spouting the virtues of their position in an effort to persuade the person to choose them? I think we can all picture a time when we’ve been in that predicament. I would argue however, that most would not realize how many times they’ve chosen the devil.
Some may choose the “devil” by driving a little more spirited from time to time, while others may opt to enjoy one too many cocktails, but how many of us choose the devil through simple inactivity or complacency?? In other words, the “Devil” presents the easy option. By simply doing nothing you could be supporting a choice that was ineffective, inaccurate, unsafe or perhaps more costly because the alternative would require effort and time; be difficult to prove and isn’t guaranteed to have a successful outcome. We may not like to admit it, but we do it.
So how does this relate to infection prevention?? Over the past several months I’ve had the pleasure of meeting and visiting with infection preventionists, environmental service workers and other HCWs across North America and noticed an unfortunately consistent theme. The easy or simple choice was being made. The status quo was winning out over more efficacious, safer and more cost effective infection prevention solutions! The “Devil” was being selected. Why, because these IP’s and HCW’s were struggling to navigate the product selection process and build an effective business case for anything new. Often times the metrics by which these organizations were evaluating new products or solutions was flawed. Quite simply, if the product was more expensive than the incumbent solution (higher price per unit of measure), then it was unlikely to be adopted. The product’s superior ability to perform in real-world conditions wasn’t being considered and most surprisingly, the total operational cost savings that could be attained by utilizing the safer, more efficacious product was also not being considered. The IP was instead forced to choose the Devil because they didn’t have the tools or time available to follow the path of the Angel.
Considering how well known the costs of HAI’s are and their burden on healthcare, it strikes me as common sense that we start considering the TRUE cost of our infection prevention practices and start measuring the savings we can accrue throughout an organization through the use of safer, more realistically effective solutions. For example, what direct costs are associated with the use of a disinfectant product? Is PPE a necessary evil? highlighted how many disinfectants require the utilization of PPE, while others do not. Clearly gloves, goggles and masks carry a direct cost associated with the use of that disinfectant. Premature Evaporation: Is your disinfectant fulfilling your every desire? identified how some disinfectants fail in keeping the surface wet for their entire contact time and therefore don’t achieve disinfection compliance. If the surface is not completely disinfected, what direct and indirect costs are potentially associated? Higher HAI’s? Citations from CMS or JCO?
As I’ve come to realize, the truth is that the selection of the “Devil” by IP’s or HCW’s is less about complacency and more about a lack of confidence in making the effective business case. Infection prevention is about collaboration. Collaborating with colleagues and departments within your facility, but more importantly collaborating with your industry partners in your efforts to implement safer, more efficacious and more cost effective solutions?? Don't forget - we're here to help!
Hasta la vista,