From Invisible to Visible - Positive Deviance Initiative

work with them more closely, bringing more and
more of them aboard.” About 20 physicians
showed up in initial maps, indicating they were
viewed by others as approachable resources.
“How has the role of the infection control unit
changed since the
PD/MRSA initiative
got underway?”
we ask Ms.
Iversen.
Sarah Leland, RN,
inpatient medical,
studying the network map
Ms. Iversen’s eyes
glow: “The network
maps tell us
that we are moving
toward building
resilience
within Billings
Clinic, so that we
are not dependent
on a few individuals
in infection control for MRSA prevention.”
Coach McCandless agrees: “Those in infection
control – Nancy, Jennifer, and Chris — had the
most to learn — or, more accurately, to unlearn,
because they kept wanting to teach the staff what
to do. Managers and experts have to let some of
the control go.” xxxi
“Billings Clinic is building resilience by ‘letting
go,’” we muse.
When we tell the infection control team that CEO
Nick Wolter said that Billings Clinic is “preventing
MRSA infections by changing relationships,”
Ms. Iversen responded: “The network maps graph
the changing patterns of interaction between
human beings, and that’s how work really gets
done.”
Kellee Fisk, vice president, people resources
added: “We, at Billings Clinic, have recognized
that most intractable problems dealing with
patient safety are behavioral, cultural, and relational.
The rising tide of improved relationships
lifts all boats.”
The lesson from Billings Clinic: Infections can be
prevented by changing relationships.
Visible Changes @ Billings
“W
hat are some visible signs of change at
Billings Clinic since the PD MRSA initiative
got underway?” we ask.
Dr. Bob Merchant noted: “Dr. Fairfax stopped
wearing a tie. Ties transmit MRSA. Now the rest
of us don’t wear ties.”
Unusual suspect Judy Reiland (center).
The Microbiology and Infection Prevention Team
during Hand Hygiene Week
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