Rửa tay
Ngô Quang Hưng | 26 tháng 09, 2006 | 
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Theo bài của Dubner và Levitt trên NY Times:
In its 2000 report “To Err Is Human,” the Institute of Medicine estimated that anywhere from 44,000 to 98,000 Americans die each year because of hospital errors — more deaths than from either motor-vehicle crashes or breast cancer — and that one of the leading errors was the spread of bacterial infections.
…
In 1847, the Hungarian physician Ignaz Semmelweis was working in a Viennese maternity hospital with two separate clinics. In one clinic, babies were delivered by physicians; in the other, by midwives. The mortality rate in the doctors’ clinic was nearly triple the rate in the midwives’ clinic. Why the huge discrepancy? The doctors, it turned out, often came to deliveries straight from the autopsy ward, promptly infecting mother and child with whatever germs their most recent cadaver happened to carry. Once Semmelweis had these doctors wash their hands with an antiseptic solution, the mortality rate plummeted.
Làm thế nào để bắt các bác sĩ rửa tay? Giải pháp 1: gọi điện thoại cho các bà mẹ các bác sĩ để bắt con các bà rửa tay trước khi khám bệnh. Các bà đã từng dạy “rửa tay trước khi ăn” thành công thì “rửa tay trước khi mổ” chắc không phải là quá vô lý. OK, giải pháp này không khả thi lắm. Nếu con cái mà nghe lời mẹ đến thế thì thế giới này đã ít có chiến tranh. Giải pháp 2: thiết kế một dạng incentive nào đó. (Incentives works wonder!)
For the next six weeks, Silka and roughly a dozen other senior personnel manned the parking-lot entrance, handing out bottles of Purell to the arriving doctors. They started a Hand Hygiene Safety Posse that roamed the wards and let it be known that this posse preferred using carrots to sticks: rather than searching for doctors who weren’t compliant, they’d try to “catch” a doctor who was washing up, giving him a $10 Starbucks card as reward. You might think that the highest earners in a hospital wouldn’t much care about a $10 incentive — “but none of them turned down the card,” Silka says.
When the nurse spies reported back the latest data, it was clear that the hospital’s efforts were working — but not nearly enough. Compliance had risen to about 80 percent from 65 percent, but the Joint Commission required 90 percent compliance.
Hừm, các bác sĩ lương vài trăm nghìn 1 năm nên 10-usd incentive chưa đủ. Đọc tiếp bài xem kết thúc.