Getting rid of the white coat
I was just given a copy of the DecisionHealth publication Inside the Joint Commission. The March 21 issue includes an article (posted below) that mentions our old white coat contamination study (free full text AJIC 2008). We reported that 23% of white coats were contaminated with S. aureus and 64% of physicians had not washed their white coats in more than a week.
The IJC article quotes the CEO of a healthcare consulting firm who suggests that many clinics have eliminated laundering services for cost-cutting reasons and didn't consider infection control. The money quote:
"The best solution from an infection-control perspective may be to get rid of the white coat altogether, but “it’s part of the old culture,” Searfoss says, and may be difficult for some physicians to part with."
I couldn't agree more.
The IJC article quotes the CEO of a healthcare consulting firm who suggests that many clinics have eliminated laundering services for cost-cutting reasons and didn't consider infection control. The money quote:
"The best solution from an infection-control perspective may be to get rid of the white coat altogether, but “it’s part of the old culture,” Searfoss says, and may be difficult for some physicians to part with."
I couldn't agree more.
important. Philip Lederer
ReplyDeletePersonally, I like the idea of getting rid of white coats; they are fomites. A couple of questions:
ReplyDelete1.What proportion of the horizontal transmission of hospital pathogens, say C. diff, do you think would be resolved by foregoing white coats?
2. We should really have an idea of the population attributable risk (PAR) % in order to determine if getting rid of white coats is worth the political capital that many hospital epidemiologists would need to invest in order to make this intervention happen. I know in Iowa was relatively easy but it might be far from that elsewhere.
It's not an issue of hospital epidemiologists convincing the hospital administration. There needs to be a cultural shift and if WC's are rebranded as potentially dangerous and non-beneficial to patients, and patients start expecting that their clinicians not wear WC's, they would be gone very quickly. Philip Lederer
ReplyDeleteI practice in New Zealand where white coats, in clinical areas, have been near extinct for 15-20 years. We still have plenty fo healthcare associated infections to worry about. What would be the best measure of difference between a white coat and a non-white coat nation?
ReplyDeletewould be interesting to compare your data to US hospitals in terms of outcomes.
Deletewould be interesting to compare your data to US hospitals in terms of outcomes.
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