Curbside Consult with Dr. Jayne 1/16/12

Jayne Gets Her Tweet On

During a recent e-mail exchange, a friend of mine repeatedly chastised me for not being on Twitter. He failed to see why someone who lives in the land of blogging and social media wouldn’t want to Tweet with the rest of the world. To be honest, I’ve been more than a little scared to take the plunge. Knowing all too well what an outrageous time suck Facebook can be, I didn’t want to get into something else that had the potential to further unmask certain addictive personality traits.

Nevertheless, I took the plunge. Signing up was deceptively easy, although I’m having a hard time deciding who to follow. I don’t want to overdo it with too much information. So far, I’m following HIStalk (of course), my BFF Inga, and my very public secret crush Farzad Mostashari (and his dashing bow tie.) You can follow my shame spiral @JayneHIStalkMD .

While I’m feeling social, I decided to share some reader correspondence. It goes back a bit, as you can imagine my inbox usually looks something like the hallways of a New Orleans emergency department during Mardi Gras (which incidentally is just a month away for those of you who plan to get your party on).

From Miami, My Amy: “I was at a physician office this week and they couldn’t get the right patient into the right room. They took me back twice and reseated me in the reception and did the same thing to another person. Made me wonder whose medical record they were viewing. I find I am becoming a “difficult” patient, bristling with all the paperwork to fill out time and time again… with the same provider.” I agree, this sounds pretty annoying and it’s also a significant patient safety issue. I do hope your physician apologized though. I that was happening in my office,I would expect my staff to make me aware so that I could say something to patients.

From Bama Bubba: “Your Curbside Consult today really charged up my growing OCD. Public restrooms never have commode lids, plus they often flush with a great torrent of surging water, not the home-based gentle swirl. This flushing surely raises huge clouds of nasty water droplets perfect for deep lung deposition. I had a remembrance of the huge toilet complex at McCormick Place in Chicago and literally dozens of commodes in narrowly separated stalls, used by folks from all over the world, being flushed at the same time. Whoa! Talk about a toxic cloud of international viruses. Excuse me, I have to go wash my hands again.”

From HealthNut: “Re: shift work food options. I worked 11-7 for a stretch and our food options consisted of coffee, colas, cigarettes, and vending machine staples of sandwiches with greenish mystery meat/cheese, lukewarm canned chili or Beanee Weenee, peanut butter crackers, candy bars, and gum. The only thing that kept us from morbid obesity was bring broke all the time because we were students.” Yeah, that and the fact that we had to run arterial blood gas samples to the lab in styrofoam cups of ice chips and run to radiology to look at actual x-ray films all night long. At my hospital, our vending machines were just updated with a new item: White Castles.

From Golfing Great: “Regarding your recent post on technology as the new scapegoat. It’s not only the users who operate the systems, but also the folks who create and maintain the systems, the training they receive, their proficiency, and their ability to anticipate — or at least understand — the needs of those users (which I try to do by subscribing to HIStalk, so thank you very much!) When problems occur, there is usually more than enough blame to go around. It’s a shame the time spent deflecting isn’t devoted to planning, training, and coordination instead. It is important to keep in mind that systems are comprised of technology, people, and processes, all of which must function properly for the system to succeed. I’m not sure that any system will ever be able to address the intentional ignorance demonstrated by people in some of the scenarios you quoted, certainly technology alone cannot. I couldn’t agree more that culture is key, particularly when, even in spite of best efforts, systems are inadequate.” Thanks for that feedback. If I could convince organizations of the need to do one thing prior to and during implementation of any health IT system, it would be this: change management.

From Mr. Clean: “What is the evidence base on best way to sanitize tablets and (especially) keyboards? Inquiring minds want to know!” There’s not a ton of data on this. Personally, I use the same wipes that we use in the emergency department, which are a healthcare-grade sanitizing wipe for hard surfaces. Low-level cleaning requires keeping the surface wet for at least thirty seconds; higher-level disinfection requires keeping the surface wet for at least three minutes, which is a little harder to do with a keyboard.

Just a few days ago, the FDA cleared a self-sanitizing hospital keyboard with the bargain price of $900. The solution uses UV light to eliminate bacteria. Another reader suggested the WetKeys Washable Keyboards, which actually look pretty cool and have much more accessible pricing. It would definitely be easier to keep those wet for three minutes than a traditional keyboard. I really like the looks of their washable flexible keyboard. Too bad Santa has already come and gone — he could have rolled one up and left it in my stocking.

Have questions about ICD-10, the most common injuries seen during Mardi Gras, or whether you should order your White Castles with double pickles? E-mail me.

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