The article on Infection Control at Massachusetts General Hospital is about situational leadership. Situational leadership is a style where the leader adjusts their leadership strategy to fit the needs of the people and the organization. The situation is similar in the article where the hospital leadership changes their approach when dealing with issues to ensure they effectively handle the problems and save no resources. Their flexibility is found in their readiness to adjust to the situation and embrace an alternative means as a solution to the problem.
The Argument of the Article
The article, Infection Control at Massachusetts General Hospital, by Huckman and Trichakis, outlines the possibility of handling a difficult situation using a different approach. Massachusetts General Hospital (MGH) is a significant healthcare facility that provides medical services to outpatients and inpatients. They wanted to prove that the screening process for the infection was slow and risked the health of other patients and their access to beds that they needed for recovery. On overage, it can work with 1.5 million outpatients and about 50,000 inpatients. These patients come in with different health issues and visit various departments, where some get discharged, and others are admitted for further observation. However, the situation was different in 2012 when the hospital was 100% occupied by patients and had to control the spread of an infectious disease (Huckman & Trichakis, 2014).
Before the disease, MGH had a system of managing the available 950 beds. Every morning, the associate director of admitting services and the patient access managers scouted the hospital looking for empty and available beds. They would ensure every department had beds for the patients they thought necessary to admit and ensure the discharging of some inpatients to relieve the hospital of jams. However, the infections brought many patients to the emergency departments, and some needed admission to a private, isolated wing. Once admitted, the patients with methicillin-resistant Staphylococcus aureus (MRSA) or with the colony had to remain in the hospital and under medication to prevent infection. Being colonized by the infection meant that the person was a carrier of the infection on their body and could transmit it to another person through contact. Therefore, they were a risk to others in the hospital and needed a bed for isolation. Furthermore, MRSA was resistant to treatment which meant it took a long time for a person to be out of the danger zone and safe for intermingling with others (Huckman & Trichakis, 2014).
The hospital’s most significant issue was testing for the infection and treatment of the patients. Due to a shortage of beds, patients with the risk of infecting others were set aside and could share a room or a bed. The problem was the screening procedure which took a long time and made the patients wait over two hours for a bed. It was a difficult situation that needed adjustment. Furthermore, there was no clear policy on discontinuing treatment, which made the situation confusing to the hospital and patients. The present screening method took a long time to understand the patient’s condition. It always gave inconclusive results, which meant risky patients continued to share a room and beds with risky ones making it a cycle of infections (Huckman & Trichakis, 2014).
Justification of the Argument
Hooper, Shoney, and Walensky, who were on the hospital management team, introduced a new trial to prove the ineffectiveness of the procedures in place. They separated the patients with the infection colony into two groups and did a non-intervention and intervention arm on the two groups. The non-intervention arm underwent the standard testing procedure, while the intervention one initiated a testing procedure in a timely manner for three days and used alternative methods. The results were different since, in the first testing on the non-intervention arm, only 6.6% of the patients were cleared and discontinued. In comparison, the intervention arm had 26% of the patients discontinued. Clearly, the standard MGH method was not working, and they needed a new one to effectively manage the infections (Huckman & Trichakis, 2014).
The difference between the standard and the new method was that the new one focused on patients in the ICU and took their samples without interference from antibiotics. Furthermore, they used a method called Polymerase Chain Reaction (PCR) to collect and test the samples. It was a high detective method that could collect samples faster and screen them for a shorter time. The hospital had previously used the method and showed 97% effectiveness. However, it was expensive to purchase and implement in the facility when it was first introduced. Nonetheless, the situation had changed, and the facility was dealing with an infection and needed to ensure patients’ safety. As such, they adopted the method and thought it suitable for testing and clearance of colonized patients (Huckman & Trichakis, 2014).
Findings of the Article
Using intervention methods that had proved effective in randomized controlled trials was a step towards improving the healthcare delivery and bed shortage situation in MGH. PCR, though expensive, was a suitable method and would have worked better in the facility. The hospital management linked it with the hospital’s computer systems and automated its functions to alert the hospital of an eligible patient for testing and possible discharge. The PCR machine became operational in 2011, and the hospital was ready to incorporate it into the functions of the healthcare providers, especially those in the emergency department (Huckman & Trichakis, 2014).
The emergency department needed the device for better functioning. They took all the patients and assisted them before sending them to the different departments that could further help them. Therefore, they had more contact with possible patients with the colonization and could handle them before admission or discharge. Introducing the system to the emergency department was a fast way to ensure patient safety, but the results were unsatisfactory. The reason was that the health providers in emergency departments were used to a particular way of dealing with issues, which meant they had difficulty adjusting to PCR requirements. Therefore, they could not consider testing using PCR as a priority. On the other hand, the management noticed and assigned the role of testing to the Clinical Research Coordinators (CRC) team. The reassignment was cheaper and promising to MGH (Huckman & Trichakis, 2014).
Implications of the Article on Criminal Justice
Situational leadership means having a flexible way of doing things and adapting to the environmental changes that come with management. Therefore, it relates to criminal justice by providing an alternative way of handling situations when they arise. The article is clear about finding a new way to manage the infections and the patient while ensuring the healthcare providers in the emergency department are doing their part. When the management applied the PCR machine to the hospital operations, the emergency department could not handle working their usual way and administering the tests (Huckman & Trichakis, 2014). There is limited communication and understanding of the importance of the new strategy. The scenario is a lesson to criminal justice that the leadership should find a way of communicating with the teams effectively and consider using other means to deliver the necessary services. Furthermore, the article teaches that despite the old method having worked in different situations and led to further growth and success, it should not be considered the ultimate solution. Instead, the criminal justice department is free to explore other measures, even the ones considered expensive, and incorporate them into their operations for better results.
Conclusion
The leadership system implemented in a place determines their progress and ability to solve their problems. The MGH demonstrated the capacity to adjust their situation and embrace changes depending on the severity of the situation. Therefore, the article shows other departments that work at organizations, including criminal justice, that adjusting and being open to exploring other options can solve problems. Furthermore, new ideas should come with better implementation processes to avoid confusion and failure.
References
Huckman, R. S., & Trichakis, N. (2014). Infection Control at Massachusetts General Hospital.[PDF].
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