One of the main topics in current hospital management is about risk management and specifically risks dedicated to infections.

The main point in managing this risk is that all employees have a stake in managing this risk. Secondly, systems or tools can help to reduce the risk, but a system can not eliminate the risk nor held responsible for the risk.

"Essential facts: 1. Infections contracted in hospitals are the fourth largest killer in America. Every year in this country, two million patients' contract infections in hospitals and an estimated 103,000 die as a result, as many deaths as from AIDS, breast cancer, and auto accidents combined. " (1)

The uniqueness of the hospital as a company unlike many others is of course the production process where patients are subject to a service often the operation) offered by a large number of medical professionals and cared by even more nursery professionals. It is this intervention process where the infection becomes a danger.

Another unique feature of hospitals is that it is open to the public. There is no one at the door who prevents people with flu to enter the area.

"The Major Problem: Poor Hygiene... ... physicians and other caregivers ("often") break the most fundamental rule of hygiene by failing to clean their hands before treating patients...
...
Cleaning hands is essential, but it's only the first step....("they") put on gloves, and then reach up and pull open the privacy curtain to see the next patient. That curtain is seldom changed, and it is frequently full of bacteria. The result? Caregivers' gloves are soiled again...

People management is the hardest job in overall business management. Especially if these "people" are highly qualified professionals that operate with a certain amount of autonomy... It is this autonomy that makes that the individual professional not easily accepts central rules and principles.

Yet as states in the beginning, all professionals have a stake in the risk and compliance to the central rules will determine the overall success of the hospital, which is in this case an infection free area. Solving an infection requires much more effort than preventing it to happen.

But there is more to a hospital than the professionals that cure and care patients...

Human resources make up the most significant part of a hospital and amongst them, the medical professionals dominate the number of employees.

Yet, a hospital is a more and more a capital intensive organization, where information systems, medical equipment and infrastructure determine the overall success of the company.
It is this combination of human resources and systems and its specific configuration that make a hospital both efficient and effective.

Sterilization is one of the most important central processes in a hospital. All tools and equipment must be sterilized before re-use. Then, the operating room is full of medical equipment.

Last but not least is an infrastructural element that is literally invisible: (clean) air. For this last there are new developments - like the virus buster (2) - that makes it possible to sterilize the air by using UV light.

This latter is an example where tools and systems may offer support in reducing the risk. The virus buster will clean (sterilize) the air and will help to reduce the chance on infections, but the system on itself will not solve the infection, nor will it be responsible. Responsibilities for risks are always assigned to employees or managers.

So in managing the risk the focus will be distributed on: measures and guidelines on human interaction (the organizational element), purchase and implementation of extra tools (the system element) and cleaning time (the business element).

Successful risk management is achieved by focusing on the organization; what's the follow-up rate on hygiene procedures and does the organization change to be more hygiene-conscious? It is partly achieved by investment in new tools and equipment (automatic doors and virus busters, etc). Yet while investing in these tools, there is a negative effect on the organizational awareness. Although systems cannot be held responsible, people imagine that with automatic doors the infection problem will be solved. Tools and equipment make the organization "lazy" which increases the risk.

Finally the business process is the part that can be measured by the risk manager. When cleaning times (to sterilize the operation rooms after an operation) decrease because of the pressure to increase the availability of operating space, the risk manager should ring a bell.

Bottom line: managing the risk of infections requires attention to people, procedures which can be summarized by: (more) discipline. The investment in tools and equipment will only give a one-time effect, similar like the "Da Vinci Inside (3):" having the latest robot technology doesn't automatically upgrade the hospital to one of the best. The same hospital may face the risk of an infection as any other. Only people (management) can prevent such a drama.