Nikolai Tesla: The Unsung Champion of Public Health

Nearly everyone knows of public health heroes such as John Snow and Edward Jenner but the  book Deadliest Enemy: Our War Against Killer Germs by Michael Osterholm and Mark Olshaker put inventor Nikolai Tesla into a new perspective for me.

Tesla was an engineer associated with the alternating-current electricity supply and its wide-use application.  Electricity brought about massive improvements in public health and infectious diseases control.  Electricity powered water pumps allowing for effective sewage systems.  Electricity also resulted in refrigeration, pasteurization, vaccine production and air conditioning (which keeps mosquitoes and other vectors out of homes). 

Not bad.

Tesla, the unsung champion of public health.

Antimicrobial Never Events! It is Time to Draw a Line in the Sand

Source:giphy.com

I  admire those who make bold, truthful statements.

This article in Infection Control and Hospital Epidemiology caught my attention. It is time for us to define and demand never events for inappropriate antibiotic use.

Antibiotic never events include antibiotic use for a non-susceptible organism,  antibiotic use for upper viral respiratory infections and antibiotic use for asymptomatic bacteriuria.

If we fancy ourselves proper stewards of antibiotic use, it is time that we draw a line in the sand.

Discontinuation of Contact Precautions in Pediatric Populations

Kudos to Dr. Emily Godbout, our newest hospital infection prevention team member, a pediatric infectious diseases specialist with dedicated training in infection prevention,  on her latest manuscript describing the impact of discontinuing contact precautions on CLABSI in pediatrics.

Although not everyone is convinced, we feel that the discontinuation of contact precautions for endemic pathogens (MRSA and VRE) can be done safely with a high reliability, horizontal infection control program.

The manuscript is available here, published in Infection Control and Hospital Epidemiology.

Thank You Albert Einstein College of Medicine: ID Grand Rounds Visit Winter 2019

Thank you Albert Einstein College of Medicine- Montefiore Medical Center for the visiting professor invitation and the for the honor of presenting ID Grand rounds on February 20, 2019.

A very special thank you to Drs. Yoram Puius, Theresa Madaline, Priya Nori, Greg Weston and Liise-Anne Pirofski for their generous hospitality. As always, I learn more from these visits than I contribute.

The topic was Hospital Acquired Infections: How Much Can We Prevent and How Hard Should we Try?  This perspective is now available as a published manuscript, here.

It is always nice to be back in New York City.

ID Physicians Have Value and We Can Prove It! For You to Share With Your Friendly Compensation Plan....

Here is a published reference to share with your friendly institutional compensation plan! 

ID physicians are valuable as published here in Clinical Infectious Diseases.  

If you consult us within 3 days of hospitalization, across a variety of different diagnoses (endocarditis, bacteremia, meningitis, TB, osteomyelitis, transplant infections etc) patients are less likely to be readmitted and will have lower total healthcare spending.  

Better care. Simple as that.

I am off to New York City tomorrow to spend a few days as a visiting professor at  

Montefiore Health System and Albert Einstein College of Medicine.

Stay tuned.

Crowdsourcing in Infection Prevention

Source: Sciencemag.org

I have been thinking of the concept of  crowdsourcing and came across this article that explores crowdsourcing applications for public health.

Crowdsourcing is a shared top-down and bottom-up online collective problem solving process which taps into the collective wisdom of the crowd. 

When faced with infection prevention management problems or problems of implementation, we should explore solutions from the crowd (eg. the hospital staff)  by way of online engagement.  This may result in creative input and inexpensive or free labor/collaborations.

A related example is the concept of positive deviance, as I have previously discussed here. One can imagine positive deviance solutions to vexing implementation struggles (such as hand hygiene, use of checklists etc) emerging from an online crowdsourcing 'innovation challenge'.

Crowdsourcing may prove a satisfice approach to infection prevention conundrums.

Art and Medicine and The Power of a Tattoo: VCU Department of Medicine Grand Rounds

The VCU Department of Medicine grand rounds last week focused on art and medicine.  The presentation was by Drs. John Nestler and Megan Lemay. They explored applications of art to medicine both for a greater understanding of the human condition and for the development of observational and critical thinking skills.   A special emphasis was placed on research models to further explore the intersection medicine and the arts, all at VCU Health.

Of particular interest was the short video (TEDx RVA) on the role a tattoo in healing the psychological scars of a mastectomy.

Here is the link for our combined publication of the Medical Literary Messenger with VCU Amendment, a collaborative art and medical literary magazine edition, to be printed this month

Stay tuned.

Hospital Infection Prevention: How Much Can We Prevent and How hard Should We Try? Perspective Now in Print

The contents of my SHEA 2018 lecture is now published as a perspective in Current Infectious Diseases Reports (with VCU co-authors Michelle Doll, Kaila Cooper and Mike Stevens).

The manuscript is available here (PubMed).

Read This:The No Asshole Rule

Here is a must read, The No Asshole Rule, by Stanford University professor Robert Sutton, PhD.The book is both insightful and spot on.

Mean, negative people exist in almost every work environment.  We even have one in the highest level of US government.

Professor Sutton recommends two simple tests to identify an asshole:

• Test one: After talking to the alleged asshole does the 'target' feel oppressed, humiliated, de-energized or belittled? 

• Test two: Does the alleged asshole aim his/her venom at people who are less powerful rather than at those people who are more powerful?

If the above to tests are affirmative, and if that pattern of behavior is consistent, then you have a certifiable asshole.

No kiss up, kick down people welcome in the workplace.