“Feature negation” is a problem in the health care industry

Automotive technology has come a long way in the last 30 years; better crash protection and shock absorbing bumpers, seat belts, airbags, anti-lock brakes and traction control systems have saved many lives.

Anticipating a reduction in accidents, insurance companies initially offered discounts to people who bought vehicles with anti-lock brakes, but cancelled it when the decline didn’t materialize. The automotive safety industry has a name for this; it’s called ‘feature negation.’ Either conscious or unconsciously, people think ‘Geez, these anti-lock brakes guarantee that I can stop on a dime and get change; why worry about following too closely?’ The improved brakes are negated by driver stupidity. Cars are getting smarter but people are getting stupider, it would seem.

This brings me to seniors care. It’s the time of year when colds, flu and especially Norwalk viruses make their rounds.

Norwalk is a member of the calicivirus family, human specific and passed in the stool of infected people. The more compromised a person is, the more vulnerable they are to being severely affected, which explains why seniors are so at risk. The most effective method to stop its transmission is good hygiene – more specifically, WASHING HANDS.

We all know the importance of being on guard against Clostridium difficile, more commonly known as C. diff, a bacterium that causes diarrhea and more serious intestinal conditions such as colitis. It is the most common cause of infectious diarrhea in hospitalized patients in the industrialized world, and is also one of the most common infections in hospitals and long-term care facilities.

A Public Health Agency of Canada study indicates that a more resilient strain of the bacteria may be present in hospitals in Quebec. The study found that C. diff was indirectly responsible for 108 deaths during a six-month period. A hospital commissioned, confidential study on the matter blamed poor hygiene.

An entire ward was closed to visitors in Joliette, Quebec in November due to C. diff. Also in November Ontario’s chief coroner announced an investigation into the suspicious deaths of 22 people in Sault Ste. Marie, which was also linked to the bacteria. This deadly chain of infection can be stopped by using routine infection control measures; again, the most effective tactic is WASHING HANDS.

I am astonished at the burden sick patients and ill staff puts on remaining healthy staff and the families of residents. Staff workloads are heavy enough, but with colleagues off sick, those healthy enough to remain at work, regardless of their discipline, must shoulder the heavy responsibility of keeping up. The resulting long hours and additional stress makes them more likely to also become sick. It’s like fighting a long grinding war with no end in sight.

SARS cost us millions of dollars and took the lives of 44 Canadians. I had hoped the outbreak would put pathogen transmission foremost in the minds of health care workers and the general public but amazingly, Norwalk and C. diff still claim many lives across the country. This isn’t the ‘new-normal,’ it’s the ‘same old, same old.’

Hand washing and basic hygiene are not cutting edge science and didn’t cost billions of dollars to develop, unlike treatments for cancer or AIDS. Stopping Norwalk and C. diff does not require radiation machines, surgery and chemotherapy. What is needed to save lives is real commitment; commitment to change the way we do things.

I sometimes wish a coroner’s inquest was called for every death in a seniors or long term care facility. How many staff called to testify would say ‘I didn’t have time, we’re too overburdened’? How many administrators would say ‘we don’t have the budget’? How many politicians, sweating profusely and arms flapping needlessly, would try to explain that ‘it isn’t a priority of this government’?

The part I would want everyone to hear is the victim impact statement from a husband, wife, son or daughter – or even a grandchild. ‘My wife was taken from me by someone who just didn’t have the time;’ ‘My father died because someone couldn’t allocate the money.’ What about home staff explaining to a jury that they did not have time to WASH THEIR HANDS.

Our medical system can spend tens of thousands of dollars replacing a person’s hips, knees and cataracts – or intervene after heart attacks and strokes, yet allow people to suffer needlessly and sometimes die because staff doesn’t take the time to wash their hands and be careful about hygiene. I do not see any acceptable excuse.

Like the drivers I began with, the problem isn’t with equipment or a lack of knowledge. We have the tools and understand the problem. Medicine improves while stupidity increases. You may feel that is unfair, but one thing is beyond dispute – people are dying needlessly.