The Garfield Project: learning from the death of our 20th President

One of my most potent, visionary, and interesting clients this year was back in February – St. Luke’s Health System in Boise. (Did you know Boise is pronounced Boissy, not Boizey?)

I could say a lot about the time I spent working with them. Their CEO David Pate had heard me speak a year earlier at a small CEO roundtable, and subscribed to this blog. When I posted my RFP for my skin cancer, he wrote and said “I’ve got a proposition. Come do your talk as Grand Rounds, and we’ll do the surgery for free.” I said “Thanks but no thanks – but since you asked…” and we started a discussion that led to a multi-day engagement, working with their leadership team and giving a keynote to a big leadership meeting last winter.

I subscribed to his blog too, and in today’s feed is a fascinating story: Learning from the 20th President. That president was Garfield, who died 132 years ago. He was shot, but the bullet didn’t kill him – an infection did, months later, almost certainly caused by the stream of doctors who stuck their unwashed fingers and tools in him to try to find the bullet.

That was a long time ago: not only did medicine not yet understand infection, we didn’t have anesthesia.

Today we have anesthesia, but as all students of health quality know, it’s still really, really, really hard to get people to wash their hands between patients. In my several years learning about medicine I’ve learned that our biggest challenge today isn’t biological – it’s behavioral: nothing improves if behavior doesn’t change, and that’s true for patients and for clinicians.

It can be done – one example is at right, from Kingston General Hospital in Ontario. Talk about a turnaround – a few years ago they were a disaster as a hospital, and today among other metrics they’re now at 95% hand hygiene! (N.B.: it was one of their patient advisors who came up with the idea of posting the number on the wall for everyone to see, internal and external!)

In today’s guest post on Dr. Pate’s blog by Chereen Langrill, of the SELECT physician network they work with, I learned about “the Garfield project” they ran for some time:

Within St.Luke’s, the Garfield Project (named for our 20th president) was created to increase hand-hygiene compliance within the Boise critical care units. That project has ended, and other efforts are now under way within St. Luke’s to continue the important work the Garfield Project began.

This is important to you and your family. As the post says:

The ripple effect of poor hand hygiene can be staggering. It takes just one person to endanger a patient by neglecting hand hygiene. Every caregiver, including volunteers, working in a patient environment must follow the same procedure. (Emphasis added)

Me being me – a marketing slogans guy – I like the catchy title “The Garfield Project.” And me being me, a social media guy, I like their use of YouTube, to bring themselves down off the mountain to where “the ordinary we” are. The post links to this 2012 YouTube about handwashing, which ends with a passing example of what cool people at health conferences are doing now: instead of a hand shake or even a fist bump, it’s the elbow bump.

I think this “Garfield Project” idea could get legs – it could be a fun-sounding basis for interacting with providers for a handwashing reminder: “Hey, don’t pull a Garfield on me!” :-)  What do you think?
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p.s. added later: With this administration’s focus on health quality, it’s a bit odd that Garfield’s page on WhiteHouse.gov minimizes the cause of death: “For a few days he seemed to be recuperating, but on September 19, 1881, he died from an infection and internal hemorrhage.” Sounds like a classic case of “These things happen” thinking!