the philosophy behind our MRSA prevention work

Jon Lloyd as you have "met" previously in this posting, has archived some of his correspondence with people not familiar with our PD/MRSA work and is letting us share them with you, the reader. Inspired by Rilke's Letters to a Young Poet, Jon is titling his collection as "Emails to a Young Positive Deviant" and this particular email really captures the philosophy of the work that we are doing:

Emails to a Young Positive Deviant

(2) Front Line Workers…the True Experts

Your staff will be your greatest source of ideas on overcoming barriers to adhering to the basic precautions like active surveillance, hand hygiene and contact isolation. Given the freedom and opportunity, your staff (RN's, housekeepers, respiratory therapists, food service, et al) will go beyond that and come up with all sorts of other infection prevention precautions that the Infection Control team hadn't thought of. At least that has been the experience at the VA Pittsburgh and the other beta sites. Your staff will become the functional IC team and the IC team will gradually ascend from the role enforcers to become the scientific base and filter for the great ideas that the staff will come to them with for validation.

The other thing that comes to mind is the importance of letting the staff who come up with the great ideas actually implement them. They may need support, but it is critical for the creator of a good idea to be able to act on it. You (MCP, ICP) shouldn't have to be the scientist, educator and do all the work in implementing their ideas. True ownership comes not only from creating the solutions but acting on them. Since we tend not to turn our backs on things we create, staff-driven solutions tend to be more durable than those that come from the outside or from the top of the organization. The closer the staff are to the solutions, the more effective, less costly, simpler, more beautiful and longer lasting those solutions tend to be.

Focus on the inherent strengths of your front line staff, especially the unlikely suspects. Draw on this untapped resource continuously. Your staff will come up with increasingly sophisticated ways of preventing MRSA transmissions and associated infections.