At Northwell Health, leaders don't discount the rare causes or sources of hospital-acquired infections.
"Preoccupation with failure is a critical mindset in trying to eliminate hospital-acquired infections," said Peter Silver, MD, senior vice president, chief quality officer and associate chief medical officer at New Hyde Park, N.Y.-based Northwell Health. "What are the one to two steps we could be potentially missing, even if they're rare [causes] … because that's what you do when you want to consider an HAI as a never event."
That means having robust decontamination processes in place for medical equipment, supplies and devices. In 2022, data from The Joint Commission showed the most challenging compliance standard for hospitals to meet was the adoption of infection prevention protocols for disinfection and sterilization of medical equipment, supplies and devices. One potential reason hospitals might've been cited so often for this is that there is still widespread use of manual cleaning, Dr. Silver said.
When done manually, "the risk of either incomplete cleaning or contamination during the cleansing process is fairly significant, and I think many sites, systems and hospitals are still relying on manual processing," he said.
Northwell's approach to decontamination is centered around three things: automation, standardization and monitoring. In many cases, automated cleaning takes place in a standardized environment with decontamination rooms. In operating rooms, the health system uses Arrowsight, a remote monitoring company, to observe decontamination processes.
While a reliable approach, it requires a significant amount of resources and space, which can be a challenge for many hospitals. "It's fairly complex and still takes not only the equipment, but very well-defined processes, procedures and highly trained people," Dr. Silver said.
Northwell also uses disposable scopes to eliminate infection risk wherever it makes most sense. For example, disposables are used in certain sites where scope procedures such as endoscopy or colonoscopy aren't performed very often, which is simpler and more cost-effective than implementing sterilization methods.
Another key part of the approach is encouraging team members to support one another, Donna Armellino, DNP, RN, Northwell's vice president of infection control, told Becker's.
"No one should ever be afraid to offer help or interject and say, 'Hey, I didn't see you have the opportunity to clean that piece of equipment — can I do it for you?'" she said. "These environments are very busy and sometimes there's emergencies, but if we all support one another, we can actually get done what needs to get done."