December 28, 2022
Excerpt—read the full article
Improving quality and access to healthcare is a daunting challenge. But some simple, low-tech ideas can help to enhance the patient experience and everyone's safety.
Ben Tre, Vietnam – Liem Thu Bui, 27, is 39-weeks pregnant and has been admitted to the maternity ward at Cu Lao Minh hospital in Ben Tre province,Vietnam for the delivery. She is staying in a maternity room that has 4 beds for patients and one small bathroom.
While she found it helpful to have a bathroom in the room, Liem remarked that every time she or her grandmother needed to wash hands before eating, or to generally maintain hygiene, they would have to wait a long time as the bathroom was often occupied (at least eight people are usually staying in the room). She did not like having to go to the outside bathroom every time she needed to wash hands, which ultimately meant she washed less frequently than she would have wanted.
Liem was getting used to the routine, until an additional handwashing station was suddenly placed in the room—outside the bathroom. Now with the handwashing facility outside the bathroom, the expectant mothers and their relatives did not have to wait for the bathroom just to wash their hands.
We are reminded again and again that handwashing with soap is important, but it becomes an utter necessity during childbirth. In fact, the original ‘discovery’ of handwashing as being important for health was made during an experiment to prevent infant mortality in a maternity ward of a hospital. The team that manages the Cu Lao Minh healthcare facility strives to provide the best possible patient care in Ben Tre province, and they demonstrate that there are always ways to improve. The fact that 11 out of 20 rooms in this hospital already had a bathroom meant it was far above the minimum requirement for hygiene facilities. But with each room hosting 4-5 expectant mothers at a time—plus husbands and children visiting in the daytime and grandmothers staying overnight— it’s normal to find at least 8-10 people at all times. Without any provision for handwashing outside the bathroom, even doctors and nurses found it difficult.
According to a joint study by the WHO and UNICEF of 66,000 healthcare facilities from 54 countries, 35% of them do not have handwashing facilities at point-of-care. Cu Lao Minh hospital would rank far better compared to many hospitals and clinics around the world that struggle with much less. The implications of a lack of facilities range across quality of care, patient comfort and safety, antimicrobial resistance, hospital-acquired infections, healthcare worker safety, and even pandemic prevention and preparedness. Cutting through all the complexity of the challenge, the team at Cu Lao Minh hospital discovered that portable handwashing stations can offer a practical and affordable way to improve the quality of care.
An exciting—and perhaps equally important—discovery was how the demand from patients for an accessible handwashing facility, and the fact that it was placed within the room, prompted their families to manage the emptying and refilling of the water. No additional burden was placed on hospital custodial staff as the would-be grandmothers, pictured above, did the job. It’s important because the maintenance of facilities (all types of facilities) is a major hurdle in the pursuit of sustained, improved health services.
This Universal Health Coverage Month, let’s call upon healthcare decision-makers to explore different ways of improving access and quality of care. There are undoubtedly some simple, creative, and low-tech ideas that are within reach. Putting handwashing within reach is just one.