M01SOH Report: Innovation in Healthcare and Patient Safety

This report explores the implementation of hand hygiene high-tech, an innovation designed to improve patient safety by addressing hospital-acquired infections within the NHS. The report discusses the rationale behind the technology, emphasizing its role in reducing morbidity rates and healthcare costs. It analyzes the technology's impact, including its ability to track hand hygiene adherence and reduce the transmission of pathogens. The implementation section focuses on the application of the Leader-member exchange theory and Kurt Lewin's Change Model to facilitate the adoption of the technology. The report also touches on the evaluation of the innovation, highlighting its potential to improve patient satisfaction and the standard of care. Overall, the report provides a detailed overview of the benefits and strategies for integrating hand hygiene technology into healthcare settings.

Running head: INNOVATION IN HEALTH CARE
INNOVATION IN HEALTH CARE
Name of the Student:
Name of the University:
Authors note:

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Table of Contents
Introduction:....................................................................................................................................2
Discussion:.......................................................................................................................................3
The rationale behind choosing such innovation:.........................................................................3
Impact:.........................................................................................................................................4
Implementation:...............................................................................................................................5
Evaluation:...................................................................................................................................7
Conclusion:......................................................................................................................................7

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Introduction:
There is a steadily growing number of technologies being introduced in the health
system which addressed the policy challenges existed due to the complex health care system. In
the previous era, patient safety has been a crucial quality improvement challenge faced by the
health care sectors which increased health care expenditure, morbidity rate and raised public
health issues (Baxter et al. 2016 : 10). While patient safety is fundamental to provide safe
and best possible care, the majority of the health care sectors experienced such quality
improvement issues which not only affected the reputation of the organization but also minimize
patient satisfaction (Reilly et al. 2016:661). According to Alzyood et al. (2018: 1340), the factor
of hygiene significantly reflects the quality of the treatment services that patients are receiving or
the ability of the health care organization to comply with the high demand for patient care.
However, hand hygiene is one of the crucial patient safety issues experienced by the majority of
the health care sectors in United Kingdom which further affected patient safety.
As discussed by Braithwaite and Donaldson (2016:333) prime reason behind this issue is
the shortage of the staffs to address high patient demands the majority of patients. Consequently,
health professionals, especially nurses were subjected to the stressors such as long shift hours,
excessive work pressure which result in job burnout, medical negligence mental health issues,
and absentees. WHO reported that one in 10 individuals dies due to the issues regarding patient
safety and 40000 patients experience ineffective patient safety every year. Majority of the deaths
due to the inability to have a duty of care as per the standard of NHS (Www.who.int 2019).
However, since in the current era, new technologies such as wearable device, robotics, genomics
and artificially intelligent, are being developed, financed and brought to the market, the health
care industry is able to reduce the high prevalence of the disease, patient safety issues and high
expenditure of health care services (Bowman et al. 2019: 9) . On such as innovation hand
hygiene high-tech which will not only improve patient safety but also will reduce high morbidity
rate associated with a hospital-acquired infection. Hence, the paper aimed to provide an in-depth
discussion regarding the rationale behind implementing the innovation, impact of the
innovation relevant leadership theory and management theory to implement the innovation in the
following paragraphs.

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Discussion:
The rationale behind choosing such innovation:
Hospital-acquired infection poses a greater risk to the patients, visitors as well as staffs
and incur high cost for NHS (National Health Service) (Davis et al. 2018: 157). Hospital-
acquired infection is those infections which patients acquire while admitting to the hospital and
receiving care. While hospital-acquired infection can occur due to several different reasons, a
significant number of researchers highlighted the role of improper hand hygiene of health
professionals in facilitating hospital-acquired infection which further questioned the patient
safety (Zingg et al. 2015:220). The NICE report suggested that approximately 300,000 patients
every year in England develop a healthcare-associated infection a result of the negligence of safe
and responsive care (Percival et al. 2015: 334.). In 2011, the prevalence of healthcare-associated
infections in health care sectors in England was 6.4%. In 2017, incident rate of the infection in
adult’s high patients was 17 individuals per 1000 people, indicating a high prevalence of
infection (Tajeddin et al. 2016). Deeny et al. (2015: 3367), reported that clostridium difficile,
MRSA, Escherichia coli are the common pathogens that cause nosocomial infections in patients
within 48 hours of admission of patients, especially older adults. In 2007, C. difficile associated
hospital-acquired infection was a major concern of health commission and new legislations were
designed to provide a high quality of care to the patients who are seeking medical assistance
(Hong et al. 2016: 951.). A substantial amount of this infection can be prevented with simple
safety measure such practice of hand hygiene. While it comes to patient safety, health
professionals cannot be termed as negligent as it is part of professional ethics to provide safe and
responsive care according to the quality standard of care. For health care providers, following
hand hygiene protocol is one of the simplest action one can take to reduce the instance of
healthcare-associated infection (Iwami et al. 2017: 12520). However, due to negligence, high
workload, health professionals failed to perform proper hand hygiene which further impacted the
quality of care. Hand hygiene high tech is one such innovation that addresses the crucial issues
associated with hand hygiene and reduces the high prevalence of patient safety. While a trained
observer can monitor when health professionals are performing hand hygiene, the approach is
limited as works would be more prominent and aware of the fact that they are being watched
(Srigley et al. 2015:51 ). Hence, hand hygiene high tech is more than perfect technology drive
approach of tracking adherence of the health professionals to the protocol using tele tracking

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technologies. Dyson and Madeo (2017:280), highlighted that in this case, health
professionals will wear an identification badge along with a wireless receptor as part of their
uniform, and additional sensors will be located on dispensers of hand gel and soap at the bed of
each patient bed and on ward sinks. The sensor will record when professionals with badge will
enter and exit along with whether they are performing hand hygiene or not before exiting and
after entering (Moller-Sorensen et al. 2016:339). In this way, the technology is able to track the
durance of health professionals with three of the World Health Organization's five moments for
hand hygiene such as before touching patients, after touching patients and patient’s surroundings
(Iwami et al. 2017: 12520). In the patient room, if health professionals perform hand hygiene
twice then they will score 100 and if they perform once they will score 50. In this case, with the
assistance of this hygiene system, the healthcare professionals would be able to maintain an
adequate level of hygiene, able to evaluate their gap in professional practice and therefore,
reduce the chances of transmission of the pathogen that can cause infection and substantially
improve the quality of care.
Impact:
While observed professionals can undertake direct observational methods in order to
evaluate the adherence of the health professionals to the hand hygiene protocol, technological
journey of observation is way more smoother compared to direct observation as it eliminates the
risk of false record because professionals will be aware of observation and more inclined to act
according to the protocol (Dyson and Madeo 2017:281). Considering the perspective of the
health care system, the impact of technology is somewhat positive in addressing the
issues regarding the quality of care and patient safety and the high cost of health care services.
Moller-Sorensen et al. (2016:339), highlighted that this technology is able to address the
adherence of the health professionals with the hand hygiene protocol which will further reduce
the high prevalence of healthcare-associated infection. While the majority of the health
professionals are not careful while exercising their fundamental responsibility, this technological
approach will keep a track of their hand hygiene performance while they will be near the
patient and reduce the possibility of transmission of infection (Haque et al. 2017:163).
Consequently, it will reduce the direct and indirect cost of the health care services for addressing
the hospital-acquired infection and increase the person-centered care approach in the delivery of
care (Dyson and Madeo 2017: .280). It is cheaper and generates the data continuously to assess

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the compliance of all professionals without interfering patient care. According to Masroor et al.
(2015:102), the technology is an excellent approach towards workload reduction as the
technology will minimize the workload of staffs who will monitor the hand hygiene compliance
and front line professionals who will provide care patients experiencing a severe nosocomial
infection. Consequently, it will improve patient satisfaction and reduce hospital admission per
year. Hagel et al. (2016: 962.), highlighted that since health professionals are somewhat familiar
with the technology because similar technology is used by the professionals to track assets and
patients, it will be an easy transition to hand washing compliance tracking for management and
professionals and reduce the challenges of acceptance. Moreover, Masroor et al. (2015: 103),
opinioned that with the assistance of this technology, the manager can be able to reach to each
employee and evaluate their practice. The technology will be used in a way of appreciation for
the health professionals that they are doing a good job rather than they are not exercising their
common practice (Gould et al. 2017 : 172). It will motivate professionals, support their
responsibility, reduce job burnout and associated stress and they will be more inclined to provide
safe and responsive care to the patient according to NHS standard. Hence, this will be a
cornerstone in the health care industry which will set a new benchmark for the standard of care.
Implementation:
While small changes occur in the health care sectors on a daily basis, nearly
every organization experience major changes at least once in existence. In this context of
change, leadership is one of the crucial skills of managers to cope up with the transformation and
resistance of the employees towards new change. While implementing change, every
organization require efficient leaders to take control of the overall process of change,
workforce retention according to change, effective communication across all layer of
employment, management of fears and collaboration. Hence, it is fundamental to adopt
accurate leadership theory for implementing the changes in the organizations and bring
maximum success out of it. In this current context of the implementation of innovation that was
discussed in the above sections, the best suitable leadership theory is Leader-member exchange
theory. According to Martin et al. (2016: 121), it is a relationship-based approach
to the leadership which focuses on the two-way dynamic relationship between leaders and the
followers. The theory suggested that leaders form a strong trust, emotional as well as the respect-

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based relationship with the employees and make them the active part of decisions making,
responsibility and available resources that can bring the success (Breevaart et al. 2015: 760).
Consequently, employees will have the opportunity to develop different competencies,
interpersonal skills and it will improve the team performance. The employees feel empowered
and able to take an active part in decision making. The key stakeholders are required to involve
in this process for facilitating the process of change. Considering the cultural and power
perspective, the incorporation of the employees in the decision making facilitate workplace
culture by bringing awareness and facilitates proper power balance between leaders and
followers. Hence, in this current context, this leadership theory can be applied in implementing
hand hygiene high tech with the assistance of Kurt Lewin's Change Model. This model
represents a very simple as well as a practical model for implementing the change process with
the assistance of three steps such as unfreezing, changing and refreezing.
Considering the first step of the model, as many employees would be naturally resistant
towards the proposed change, the goal of the unfreezing step is to create an awareness of the
innovation of that would be implemented (Hussain et al. 2018: 125). In this case, the
management can apply the leadership theory such as leader-member exchange theory in order to
create awareness. The managers are required to design a meeting session where through face to
face communication, the employees are required to provide information regarding the change
and benefit change and require to gather information. Communication is particularly significant
during this stage so that employees can become informed regarding the change and they can
provide feedback as well as take an active part in the implementation of change. This
management theory along with leadership approach motivate employees to take part in the
process of implementing change and improve power balance.
The second stage is also referred to the transition stage where employees begin to learn
the new behaviors, processes, and ways of thinking. Hence, in order to facilitate this step, the
health professionals are required to provide with education, technical and non-technical training
regarding the use of the technology and so that they can accept the change would be
implemented (Wojciechowski et al. 2016:2). Throughout the process of support health
professionals should be reminded of the reasons behind implementing the change and how it will

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benefit each of them in altering the current practice of providing safe care to the patient once it is
fully implemented in the organization.
The last stage of the change model is refreezing where the employees are required to
make efforts to stabilize as well as solidify the new state after the change. The organizations are
required to evaluate whether the change is effective or not through auditing. The barriers to
proper implementation of the change are required to overcome through proper alteration of the
current strategies (Wojciechowski et al. 2016).
Evaluation:
While the success rate of the organization change is high, the failure rate of
the implemented change is equally high despite accurate leadership theory. In this current
context, in order to measure whether the innovation was successful in addressing the concerns of
health care and patient safety, the proper evaluation method is required to adopt. The outcome
measures parameter include a reduction in the number of complaints from the patients regarding
safety issues or quality of care that they had received from the health professions and reduced
nosocomial infection rate along with the reduced rate of the hospital admission. In order to
measure the success rate of innovation, healthcare organizations can use different kinds of
measuring tools such as survey, interview, performance reviews, and patient feedback. The
interview is an excellent qualitative measure for gathering the perspective of health professionals
and patients regarding innovation (Blewett et al. 2016 : 1962). The interview will provide the
idea that whether innovation has a positive impact on the organization or not. Considering the
survey, the survey can be conducted for gathering the point of view of the patients who are
admitting in the hospital or family members of the patients (Blewett et al. 2016: 1963). The
performance review can be gathered in this case, for determining the compliance rate of the
health care professionals and appreciating the health professionals are excellent at their job. The
feedback of patients can be gathered regarding the changes and quality of care they are receiving
(Blewett et al. 2016: 1963). The audit is another excellent observation tool to measure
infection rate of nosocomial infection and hospital admission. The adequate and proper usage of
these evaluating tools would offer a fair idea to the organizations whether the objectives with
which they implemented the innovation had been achieved or not.

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Conclusion:
In a concluding note it can be concluded that while patient safety is one of the primary
priority of providing health care services to the patient, it is a most neglected area in the health
care which further contributed to the high prevalence of the disease. Even though hospital-
acquired infection can occur due to several different reasons, a significant number of researchers
highlighted the role of improper hand hygiene of health professionals in facilitating hospital-
acquired infection which further questioned the patient safety. Hence, this paper aimed to
propose one such innovation such as hand hygiene high tech with sensor to address patient
safety. With the assistance of this hygiene system, the healthcare professionals would be able to
maintain an adequate level of hygiene, able to evaluate their gap in professional practice. This
innovation can be implemented with the assistance of leader- member exchange theory and Kurt
Lewin's of change model. The success rate of innovation can be measured through survey
interview and feedback.

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References:
Alzyood, M., Jackson, D., Brooke, J. and Aveyard, H., (2018). “An integrative review exploring
the perceptions of patients and healthcare professionals towards patient involvement in
promoting hand hygiene compliance in the hospital setting”. Journal of clinical nursing, 27(7-8),
pp.1329-1345.
Baxter, R., Lawton, R., O’Hara, J. and Sheard, L., (2018). “ISQUA18-1659 Positive Deviance to
Improve Patient Safety: Learning from Four Studies in the UK”. International Journal for
Quality in Health Care, 30(suppl_2), pp.10-10.
Blewett, L.A., Dahlen, H.M., Spencer, D., Rivera Drew, J.A. and Lukanen, E., (2016). “Changes
to the design of the national health interview survey to support enhanced monitoring of health
reform impacts at the state level.” American journal of public health, 106(11), pp.1961-1966.
Bowman, L.G., Hardesty, S.L., Sigurdsson, S.O., McIvor, M., Orchowitz, P.M., Wagner, L.L.
and Hagopian, L.P., (2019). “Utilizing Group-Based Contingencies to Increase Hand Washing in
a Large Human Service Setting”. Behavior Analysis in Practice, pp.1-12.
Braithwaite, J. and Donaldson, L., 2016.” Patient safety and quality”. The Oxford handbook of
health care management, pp.325-351.
Breevaart, K., Bakker, A.B., Demerouti, E. and van den Heuvel, M., (2015). “Leader-member
exchange, work engagement, and job performance.” Journal of Managerial Psychology, 30(7),
pp.754-770.
Davis, R., Parand, A., Pinto, A. and Buetow, S., (2015). “Systematic review of the effectiveness
of strategies to encourage patients to remind healthcare professionals about their hand hygiene.”
Journal of Hospital Infection, 89(3), pp.141-162.
Deeny, S.R., Worby, C.J., Tosas Auguet, O., Cooper, B.S., Edgeworth, J., Cookson, B. and
Robotham, J.V., (2015). “Impact of mupirocin resistance on the transmission and control of
healthcare-associated MRSA.” Journal of Antimicrobial Chemotherapy, 70(12), pp.3366-3378.

10
INNOVATION IN HEALTH CARE
Dyson, J. and Madeo, M., (2017).” Investigating the use of an electronic hand hygiene
monitoring and prompt device: influence and acceptability. “Journal of infection
prevention, 18(6), pp.278-287.
Gould, D. J., Creedon, S., Jeanes, A., Drey, N. S., Chudleigh, J., and Moralejo, D. (2017).
“Impact of observing hand hygiene in practice and research: a methodological
reconsideration.” Journal of hospital infection, 95(2), 169-174.
Hagel, S., Reischke, J., Kesselmeier, M., Winning, J., Gastmeier, P., Brunkhorst, F.M., Scherag,
A. and Pletz, M.W., (2015). “Quantifying the Hawthorne effect in hand hygiene compliance
through comparing direct observation with automated hand hygiene monitoring. “infection
control & hospital epidemiology, 36(8), pp.957-962.
Haque, A., Guo, M., Alahi, A., Yeung, S., Luo, Z., Rege, A., Jopling, J., Downing, L., Beninati,
W., Singh, A. and Platchek, T., (2017). “Towards vision-based smart hospitals: A system for
tracking and monitoring hand hygiene compliance”. arXiv preprint arXiv:1708.00163.
Hong, X., Qin, J., Li, T., Dai, Y., Wang, Y., Liu, Q., He, L., Lu, H., Gao, Q., Lin, Y. and Li, M.,
(2016). “Staphylococcal protein a promotes colonization and immune evasion of the epidemic
healthcare-associated MRSA ST239”. Frontiers in microbiology, 7, p.951.
Hussain, S.T., Lei, S., Akram, T., Haider, M.J., Hussain, S.H. and Ali, M., (2018).” Kurt Lewin's
change model: A critical review of the role of leadership and employee involvement in
organizational change”. Journal of Innovation & Knowledge, 3(3), pp.123-127.
Iwami, M., Ahmad, R., Castro-Sánchez, E., Birgand, G., Johnson, A.P. and Holmes, A., (2017).
“Capacity of English NHS hospitals to monitor quality in infection prevention and control using
a new European framework: a multilevel qualitative analysis. BMJ open, 7(1), p.e012520.
Martin, R., Guillaume, Y., Thomas, G., Lee, A. and Epitropaki, O., (2016). “Leader–member
exchange (LMX) and performance: A meta‐analytic review.” Personnel Psychology, 69(1),
pp.67-121.
Masroor, N., Doll, M., Stevens, M. and Bearman, G., (2017). “Approaches to hand hygiene
monitoring: from low to high technology approaches.” International Journal of Infectious
Diseases, 65, pp.101-104.

11
INNOVATION IN HEALTH CARE
Moller-Sorensen, H., Korshin, A., Mogensen, T. and Hoiby, N., (2016). “New technology
markedly improves hand-hygiene performance among healthcare workers after restroom
visits”. Journal of Hospital Infection, 92(4), pp.337-339.
Percival, S.L., Suleman, L., Vuotto, C. and Donelli, G.,( 2015). “Healthcare-associated
infections, medical devices and biofilms: risk, tolerance and control.” Journal of medical
microbiology, 64(4), pp.323-334.
Reilly, J.S., Price, L., Lang, S., Robertson, C., Cheater, F., Skinner, K. and Chow, A.,( 2016). “A
pragmatic randomized controlled trial of 6-step vs 3-step hand hygiene technique in acute
hospital care in the United Kingdom.” infection control & hospital epidemiology, 37(6), pp.661-
666.
Srigley, J.A., Gardam, M., Fernie, G., Lightfoot, D., Lebovic, G. and Muller, M.P., (2015).
“Hand hygiene monitoring technology: a systematic review of efficacy.” Journal of Hospital
Infection, 89(1), pp.51-60.
Tajeddin, E., Rashidan, M., Razaghi, M., Javadi, S.S., Sherafat, S.J., “Alebouyeh, M., Sarbazi,
M.R., Mansouri, N. and Zali, M.R., (2016). The role of the intensive care unit environment and
health-care workers in the transmission of bacteria associated with hospital acquired
infections”. Journal of infection and public health, 9(1), pp.13-23.
Wojciechowski, E., Pearsall, T., Murphy, P. and French, E., (2016). “A case review: Integrating
Lewin’s theory with lean’s system approach for change.” Online journal of issues in
nursing, 21(2).
Www.who.int (2019). Patient safety. [online] World Health Organization. Available at:
https://www.who.int/patientsafety/en/ [Accessed 17 Aug. 2019].
Zingg, W., Holmes, A., Dettenkofer, M., Goetting, T., Secci, F., Clack, L., Allegranzi, B.,
Magiorakos, A.P. and Pittet, D., (2015). “Hospital organisation, management, and structure for
prevention of health-care-associated infection: a systematic review and expert consensus.” The
Lancet Infectious Diseases, 15(2), pp.212-224.