A few months ago, as I drove my daughter to the airport on Interstate 240 for her summer internship in Boston, I read the overhead message sign: “TN ROADWAY FATALITIES 371 — PLEASE DON’T BE NEXT” The same day, walking into my hospital’s ICU, I saw a sign stating “104 Days Without a Fall”
Providing data is one way to change behavior. It can be used for the purpose of reducing roadway fatalities or decreasing medical injuries. But is it effective? I wasn’t sure.
As we drove farther, I saw the speed monitor on the road to the airport terminal flashing my decelerating speed from 50 mph down to 25 mph, which is the speed limit on the terminal road. Providing data with individual feedback was effective in making me slow down, but I saw other cars overtaking me.
That is when I saw a police car with a radar gun pointed at oncoming traffic, and another officer giving a motorist a likely speeding ticket for not decelerating. It seems that where data and individual feedback failed, regulation and enforcement were effective.
As a doctor, I treat patients, and I also work as a public health educator, encouraging preventive practices among health care workers, such as washing hands, providing vaccinations and avoiding unnecessary urine or blood catheters. I encourage patients to eat less, exercise more and adhere to their medication regimen.
The more effective we are in changing health care worker behavior, which is a major cause of medical errors, the lower the rate of infections and adverse events, such as improper drug dosing.
The more effective we are in changing patients’ health behavior, which is 30 percent of the cause of underlying illness, the lower the burden of heart disease, diabetes and strokes.
Yet behavior change is hard to accomplish. Even with data, feedback, regulation and enforcement. Sometimes, something more is needed — like a coach.
QSource, Tennessee’s Medicare Quality Improvement Organization, is providing quality improvement coaches to reduce hospital infections and readmissions. Also, Healthy Memphis Common Table, in its new initiative to improve the quality of care, is providing nurse coaches to im
prove office processes and patient care.
It’s the same way an internship for my daughter provides the guide and the coaching to step into a career. College is the first step for a change in knowledge and attitude, and an internship is the second step of putting knowledge into practice.
A few weeks ago, when I picked up my daughter at the airport, the signage notified me that the number of deaths on Tennessee roadways had gone up to 593 and now we are at 693.
So far, the number of deaths since April, when the signage was started, have not declined compared to last year. This effort may take more than data, maybe a driving coach. But TDOT has it right by displaying the data to increase awareness and an attitude and behavior change.
Source: Commercial Appeal