Tuesday, February 25, 2014

Moving to the next level, Preventing Healthcare Associated Infections!


Honorable Governor Edmond G. Brown Jr.                                                             February 24, 2014

The Great State of California

c/o State Capitol, Suite 1173                

Sacramento, CA 95814

 

Dear Governor Brown,

Thank you for your interest in patient safety, I really appreciated it. My advocacy for the Prevention of Healthcare Associated Infections(HAI) in our Veteran’s Administration Hospitals (VAH), according to the U.S. Department of Health and Human services, a preventable disease, is devoted to supporting those who help others, much like yourself, “thank you”! This letter was originally addressed to Mr.  Tom Garcia, Senior Field Representative for the Honorable Assembly member Rocky Chavez, a fellow Marine, after passively mentioning my advocacy to Mr. Garcia at a recent Chamber of Commerce networking lunch, I commented about Assembly member Chavez’s  commitment to supporting Veterans and he asked me to provide more information about my advocacy and let me know that the Assembly member Chavez is now on the health committee. Sorry about the length and challenges brought forward, opportunity is upon us, please forgive my direct approach, my time is limited, perhaps our common ground.

The impact of HAI in our VHA , for the most part, is not reported, although there is interest from several groups supporting more transparency. My only opportunity to support the VAH is to improve the entire healthcare system in California via “Best Practices”, a product of “evidence based medicine”, being collected and posted in a “Database of Best Practices for the Prevention of HAI” at the California Department of Public Health(CDPH), covered by the freedom of information act, based on the concept of the U.S. E.P.A.’s Puget Sound Storm Water Runoff Best Management Practices and challenged world-wide to be continually improved and monitored by an already funded state of the art monitoring system at the CDPH.

 One hospital in California has not had a case of Centerline Associated Bloodstream Infections(CLABSI) in nearly eight(8) years yet thousands will lose life or limb per annum  in California let alone the fiscal cost.

Let’s consider a known “best practice” to prevent CLABSI, at the federal level the VA is awaiting feedback concerning “best practices”  from the USDHHS who are awaiting and sometimes funding  the development of "best practices” at the state level, the federal VA will then advise the regional VAH  concerning “best practices” who are also watching for state level developments.

 The problem, California is not developing or accepting “any” best practices for the prevention of HAI and the CDPH avoids, at all cost, the term “best practice”. The only possible reason for the CDPH, a fully California taxpayer funded entity, to not facilitate “best practices” is their very cloudy relationship with the U.C. medical system, another asset of the California taxpayers, they seem to share addresses and nearly all of their staff have a history in the UC system.  Recently, one of the UC hospitals received an “F”, the lowest possible score, for patient safety from the Leapfrog group, a privately funded monitoring system, the CDPH monitoring system reports only if a facility is improving or regressing with no indication of current status despite the fact that they do collect the statistics. The fact that the U.C. medical system is a “teaching” system, one excuse used to defend the poor rating, does not bode well for the taxpayer or patients across the state. The CDPH’s claim that “more than half of the CLABSI cases are preventable” virtually “green-lights”  some form of socially acceptable statistics concerning the needless loss of life and fiscal waste in our state. The most profound impact of the lack of commitment at the CDPH to any “best practices” is every healthcare facility has to create their own “best practices”, replicated hundreds of times across our state, it is hard to imagine what criteria is used to train staff or the entropy caused by budget cycles and turnover. 

  Recently the Federal O.S.H.A.  has declared an interest in developing and adapting “best practices” concerning patient and workplace safety leaving the efforts at  the CDPH highly questionable and virtually irrelevant.

 The actual plan to combat HAI at the CDPH is to use their monitoring system to identify failing systems and flood them with staff and resources they do not have to bring them back to socially acceptable statistics, how this will  “prevent “ HAI completely eludes common sense.

 Organized labor is dong next to nothing in our state concerning sending their members into a needlessly dangerous workplace, the Honorable Governor Brown’s “Let’s get healthy California” is a good start, HAI is prevented by a highly motivated and empowered healthcare staff member accepting a leadership role in the implementation of a known “best practice”, nothing more, nothing less and this will not happen without a commitment from organized labor to educate and empower their members accordingly.

 The CDPH has a legal responsibility to prevent HAI, a preventable set of diseases, and should be much more aggressive concerning patient safety verses their currently defensive posture, they need to choose between protecting the bottom line of state assets or protecting California citizens from preventable diseases and massive amounts of fiscal waste in our healthcare system.

 Do we have the “will” to prevent HAI, your interest leads me to believe we do, the technology and “best practices” are already there and once again, thank you for your interest and yes, the term “Best practice” is the key, we have “control guidelines”, “guidelines for prevention” and “recommendations” but never the term “best practice”, hopefully you as the Honorable Governor will at least get the respect of an answer which I have not receive in over two years of humbly asking the staff at the CDPH.

Respectfully,

 

Michael H. Slavinski                                              http://h-a-i-5.blogspot.com

 

cc:

Honorable California Senator Ed Hernandez

Chair, Committee on Health Care

 

Honorable  California Senator Mark Wyland

 

Honorable California Senator William W. Monning

 

Honorable California Assembly member Rocky  J. Chavez

 

Honorable California Assembly member Katcho Achadjian

 

Diana S. Dooly

Secretary

California Department of Public Health

 

Ms. Kathleen Billingsley

Chief Deputy Director

California Department of Public Health

 

Ms. Debbie Rogers, RN, MS, FAEN

Deputy Director

Center For Health Care Quality

 

Ms. Dana Woods

CEO,

American Association of Critical Care Nurses

 

SEIU-UHW

Executive Board

 

Mr. Chuck Idelson

Communication Director

California Nurses Association

 

Mr. Tom Garcia

Senior Field Representative for the Honorable Assembly member Garcia

 

Mr. Eddie W. Hartenstrin

Publisher and Chief Executive Officer, Los Angeles Times

Publisher and Chief Executive Officer,Tribune Company

 

Ms. Pam Kehaly

Chief Executive Officer,

 Anthem Blue Cross

Staff, Anthem Blue Cross

"If we can improve the quality of care, that will translate into lower cost," Anthem President Pam Kehaly said. "These are real dollars."

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Happy kids, courtesy US Peace Corps 

Sunday, February 23, 2014

OSHA & Healthcare Associated Infections?


February  23, 2014

Jorge Palacios

California Department of Public Health (CDPH-CHCQ-HAI)

Re: "Database of Best Practices for the Prevention of Healthcare Associated infections" according to

         OSHA

 

Dear Mr. Palacios,

 Once again, please allow me to thank you and the entire staff at the California Department of Public Health for your efforts concerning patient safety, I really appreciate it.

 The concept of a “Database of Best Practices for the prevention of Healthcare Associated Infections(HAI)” is now in stone:

 


 Who knew the U. S. Department of Labor and the good work of the American Association of Critical- Care Nurses(AACCN) would dramatically improve patient and healthcare efficiency and safety in our state by defining HAI as a workplace safety issue.

 More than likely OSHA has no idea what they have done and the CDPH has no choice but to adapt “best practices for the prevention of HAI” or risk becoming irrelevant in HAI prevention.

 These ”best practices” should be based on evidence based medicine, introduces to all teaching schools in California as mandatory training and should be monitored by the current monitoring for opportunities for improvement in addition to being made available to be challenged world-wide.

 Advantages, the burden of every “silo “ creating their own “best practices” is a tremendous and unnecessary burden traditionally producing marginal gains only to be lost with turnover and marketplace changes.

 The words “best practices” will force the US Department of Health and Human Services(USDHHS) to adapt them, currently they are awaiting and sometimes funding “best practices” to be developed at  the state level, California has been avoiding calling anything a “best practice” for far too long and thousands of lives have been needlessly lost and billions in fiscal waste from a very dysfunctional plan of action are well documented.

 How do our Veteran’s gain from the posting of “best practices”, the US Veterans Affairs are waiting for the USDHHS to deliver “best practices for the Prevention of HAI” and have been for the past few years according to my research.

 The value of standardized processes delivered by empowered healthcare staff members assuming a leadership role, up, down, 360 degrees around has proven to be able to combat HAI and the CDPH should demand nothing less from all healthcare facilities in California, perhaps the “bright future” of healthcare.

 The interesting part of OSHA getting involved, you usually do not see OSHA in your facility until a life is lost, this is going to be very interesting but their resources are limited and I would appreciate the CDPH HAI program to make your “Database of Best Practices for the Prevention of HAI” available to OSAHA to give them a head start and direction as to where best invest their resources. Needless to say, I will be sending the Honorable President of the United States a warm thank you as a very much appreciated investment in improving the safety and efficiencies of healthcare.

Once again, thank you and the entire staff at the C.D.P.H. for all that you do concerning patient safety.

Sincerely,

Michael H. Slavinski                                http://h-a-i-5.blogspot.com





Sunday, February 9, 2014

Leadership & the Prevention of Healthcare Associated Infections


Jorge Palacios                                                                                     February 9, 2014

California Department of Public Health (CDPH-CHCQ-HAI)

Re: Leadership & the Prevention of Healthcare Associated Infections(HAI)

Dear Mr. Palacios,

 Once again thank you and all of the staff at the California Department of Public Health for the excellent work you are doing concerning the prevention of Healthcare Associated Infections(HAI), I really appreciate it!

 My advocacy for the prevention of HAI in our Veteran’s Hospitals has identified the fact that preventing HAI in our entire medical system here in California will be the result highly motivated healthcare staff members, custodian to CEO, executing a known process, assuming a leadership role, up, down and 360 degrees around, in a professional manor with real-time feedback from the C.D.P.H.’s  current monitoring system and input form an educated patient.

Recently I was involved in a dialog with healthcare professionals concerning education of front line healthcare staff concerning leadership, their assumption of the complexity involved in this educational process was astounding so I sent them a link of the following flash card for the study of the 14 traits of leadership. Please follow up with the test part, our class we run here at our humble business is to simply go around the class and ask each associate to describe one trait and how it could be applied in decision making out on the shop floor. The fact that you can take this decision making “grid” home with you and become a better wife, husband, mother, father or fiend is a byproduct beyond reproach.


The “known process” for the prevention of HAI, already underway at the CDPH, much like the  U.S. E.P.A.’s Puget Sound Storm water runoff Best Management Practices, via the freedom of information act, even a less than optimal process to be challenged and improved worldwide, despite the simplicity the six-sigma experts will flock to your “database”.

 The educated patient, if we can spend millions of dollars to teach our kids the value of washing their hands, can we ask them to ask their healthcare provider if they did?

 Preventing HAI, the technology is there today, as per Ms. Pam Kehaly, Chief Executive Officer, Anthem Blue Cross, it is a matter of “do we have the will”?

 Once again, thank you for your interest in my advocacy and all that you do to help others in the Great State of California, I really appreciate it!

Michael H. Slavinski

"If we can improve the quality of care, that will translate into lower cost," Anthem President Pam Kehaly said. "These are real dollars”