Whither the White Coat? Oh Yeah....

Photo credit: Mike Edmond

Oh yeah, the iconic white coat is once again questioned as a fomite in this New York Times article. The SHEA expert guidance on healthcare worker apparel is referenced therein along with other quality publications from my colleagues in hospital epidemiology.

Health systems can effectively minimize patient contact with infrequently laundered white coats by way of a bare below the elbows approach to inpatient care. This can be done as an infection recommendation with nudges and role modeling. 

Without a mandate we have achieved >80% compliance with bare below the elbows at VCU Health, as reported in our latest publication on the topic.

Whither the white coat? To the back of the door hook.

On a Tangent: Mark Twain and a Parting Quote From My Week at SHEA 2019

I  am back from SHEA Spring (Boston, MA) and back home in Richmond, VA. See conference related blog posts here- Day 1, Day 2, Day 3.

Conferencing does not allow for much free time. However, from my erratic readings this past week in a book I purchased during my pre-conference meandering at the famed Brattle Book Shop ( A Bibliophile in Boston blog post here), I leave you with these cogent words from Mark Twain:

Clothes make the man.

Naked people have little or no influence in society.

Amen!

Back to work on Monday.

SHEA Spring 2019 Comes to a Close!

SHEA Spring 2019 comes to a close!

Congratulations to the Society and the Planning Committee on a hugely successful event. You have set a high bar for our next annual meeting.

Very proud to be a SHEA member.

I am exceedingly proud of the VCU Hospital Infection Prevention Program (HIPP) Team. It was a pleasure to see their work referenced by other speakers. The VCU HIPP team really makes it all worthwhile.

As always, I learn more than I contribute at these events.

SHEA 2019 Day 2: VCU Hospital Infection Prevention Program

 L to R: The Blogger, Dr. Nicole Vissichelli (fellow), Dr. Pam Bailey (fellow), Dr. Michelle Doll (assistant professor), Kaila Cooper BSN, RN (IC Director), Rachel Pryor RN, MPH (IC Data and program/research manager), Dr. Barry Rittmann (fellow), Dr. Jacob Pierce (IM resident) and Dr. Michael Stevens (associate professor). 

I am proud to recognize the amazing members of the VCU Hospital Infection Prevention Program and Infectious Diseases team. All are involved in our academic and scholarly work presented at SHEA Spring 2019.

Thank you to SHEA for encouraging and supporting the participation of trainees in the scientific program.

The future of infectious diseases and infection prevention is now, with our high quality and promising trainees.

(Photo credit: Dr. Mike Stevens)

SHEA 2019 Day 2: Session on Organizational Culture and Why it Matters

Thank you to the conference organizers and to my esteemed colleagues Drs. Vineet Chopra, Keith Kaye and Barbara Braun. It was an honor to share the stage with you. More importantly, thank you to the generous audience for their kind attention.

A special gratitude goes to the session moderators,  Drs. Susy Hota and Michelle Doll.

Organizational culture matters! We may not be able to measure it easily and it may be hard to change, but it definitely has an impact on the way we work, our feelings of contribution, our sense of burnout and our quest for safety.

As always, I learn more than I contribute from these sessions.

SHEA Spring 2019 Has Launched!

SHEA Spring 2019 has launched and promises to be high quality.

I am looking forward to the presentations from the VCU Hospital Infection Prevention Program.

Stay tuned.

A Bibliophile in Boston: Brattle Book Shop

I just arrived in Boston, Massachusetts- prior to the SHEA Spring 2019 meeting.

The images are from the famed Brattle Book Shop, one of the city’s oldest used and antiquarian book sellers. 

For me, a self-proclaimed bibliophile, there is no better way to spend a cold, rainy travel day than perusing and buying cool books. 

Looking forward to the conference so stay tuned...

Why Abstraction in Medicine is Dangerous

In the book Leaders Eat Last  Simon Sinek explores the peril of abstraction by leaders.

Abstraction separates leaders from the impact that words and actions have on others and leads us down a potentially dangerous path.

The same holds true for leaders in healthcare. When patients are seen us units of throughput (admissions/discharges), physicians are valued by clinical RVUs and safety events are summarized as numbers on a spreadsheet, abstraction occurs. 

Physician leaders in healthcare should remain clinically engaged, they should walk the walk and talk the talk, as I have previously explored here.

To not do so separates us from our patients, colleagues and the impact of our leadership decisions.

Hospital Epidemiologists Need To Be in The C-Suite

Hospital epidemiologists need to be in the C-suite.

As we are driven by the central tenet of healthcare, ‘primum non nocere,’  we should relentlessly strive for zero potentially preventable infections.  Healthcare systems espouse this ideal. Unfortunately, current leadership structure may hinder best practices in infection prevention

At present, mission goals and critical  decisions are filtered to us by way of C-suite leaders.  We are simply not part of high-level discussions and strategic decision making. This is a shame. 

We have the requisite training in epidemiology so as to make rigorous, data driven decisions and set evidence based priorities for infection prevention and safety. With this comes expertise in getting things done, grounded in implementation science.

Our ethical mandate for safe and reliable care is anchored to individual and system accountability,  we need to be in the C-suite to provide executive oversight of safety goals.

New Format is Now Live and Open Access to All! Guide to Infection Prevention in the Healthcare Setting

The new format is now live for Guide to Infection Control in the Healthcare Setting, from the International Society of Infectious Diseases.

The chapters herein are intended to facilitate the implementation of effective infection prevention and control measures across different resource levels, improve quality of care, minimize risk, save lives, and reduce costs.

Chapters have been divided into four parts: 

• Infection Prevention in the Healthcare Setting
• Hospital Acquired Infections
• Antibiotic Resistance and Antimicrobial Stewardship
• Pathogens of Epidemiologic Concern

Free and open access to all.

ID Doctors Are In High Demand and We Know It!

Source NY Times

Finally, a NY Times opinion that reflects the high demand and greater looming need for infectious diseases specialists. Too bad it was written by one of us!

Infectious diseases specialists add value to patient  care, as summarized here.  That much is irrefutable.

What we desperately need are similar viewpoints written by hospital executives, compensation plan committees and insurance companies.

That may actually have an impact, anything else falls on deaf ears.

With Borges, Bioy Casares and the Definition of an Argentine

Jorge Luis Borges (L) and Adolfo Bioy Casares (R)

Parting image from the motherland, with statues of celebrated argentine men of letters Jorge Luis Borges and Adolfo Bioy Casares in their favorite gathering spot, café La Biela.

There is a well known saying back home: An argentine is an Italian who speaks Spanish, thinks he is French and would secretly like to be English. 

All part of our multi-cultural roots.

La Casa De Argüello, The Llorens Family and My Argentine Roots

I am still far south of the border, in my native Argentina.

Last week I had the great honor of attending the initial screening of La Casa de Argüello, a documentary about my grandmother (Nelly Llorens) and aunt (Fátima Llorens) directed by my cousin Valentina Llorens (website here). All part of my argentina roots.

The opening was held at the newly renovated Teatro La Piojera, Córdoba, Argentina. 

The film trailer is below.

Emocionante.

Global Infection Prevention Gaps and Mobile Technologies For On Demand Content

Source:Colourbox

Smartphones are ubiquitous.

Kudos to my colleague Dr. Angel Desai for her recent paper on infection prevention gaps between high and low income countries.  The paper was published in the International Journal of Infectious Diseases, full access PDF available here.

Although disparities abound in infection prevention efforts between high and low income settings there is a common theme. Both have high mobile technology use, smartphones in particular, allowing for rapid point of care access to source specific infection prevention content.

The study was inspired by the evolving ISID Guide to Infection Prevention in the the Healthcare Setting, now web-based and freely accessible to all.