Learn From Front Line Workers, Make Their Work More Meaningful

Source: Blue Diamond Gallery

I recently read an article that Maryn McKenna wrote for Scientific American several years ago. The article is titled, "Clean Sweep: Hospitals Bring Janitors to the Front Lines of Infection Control." The article describes the efforts by hospitals to control the rate of patient infection, particularly those that are increasingly difficult to treat. McKenna describes how infection-control specialists have partnered with janitorial staff to tackle this perplexing problem: 

Institutions also employ infection-control specialists, who track infections and investigate their causes. Yet when the problem is bacteria on surfaces, eliminating them depends on the building-services crews. “This is the level in the hospital hierarchy where you have the least investment, the least status and the least respect,” says Jan Patterson, president of the Society for Healthcare Epidemiology of America. Traditionally, medical centers regard janitors as disposable workers—hard to train because their first language may not be English and not worth training because they may not stay long in their jobs.

At N.Y.U. Langone in 2010, Phillips and his co-workers launched a pilot project that redefined those formerly disposable workers as critical partners in patient protection. Janitors, they realized, know better than anyone else which rails are touched most frequently and which handles are hardest to clean. The Langone “clean team” paired janitors with infection-control specialists and nurses in five acute care units to ensure that all high-touch surfaces were thoroughly sanitized. In its first six months the project scored so high on key measures—reducing the occurrence of C. diff infections and the consumption of last-resort antibiotics—that the hospital's administration agreed to make the experiment routine procedure throughout the facility. It now employs enough clean teams to assign them to every acute care bed in the hospital.

What a terrific story!  I love this example of learning and performance improvement because the leaders respected the knowledge and the abilities of often-neglected front-line workers with low status in the organization.  They partnered with them to get the job done, rather than thinking that the high-status, highly educated senior people had all the answers.  Moreover, they redefined the jobs of these front-line workers, giving them new meaning.  These janitors were not simply completing a set of tasks, such as mopping the floors.  They were helping to save lives by reducing the rate of patient infection.  They were doing incredibly important work.  I see this situation as a terrific example of aligning everyone in the organization in pursuit of a shared goal.  The janitors understood clearly how their work helped fulfill the hospital's main mission of saving lives.  In too many instances, front-line workers don't understand how their efforts contribute to the fulfillment of the organization's mission.  In this case, no such confusion or lack of clarity exists.