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Hospital investigations

Covid CSI: Real-world hospital case studies

For those of us of a certain age, before the various CSI’s and House’s of the television world appeared, there was Quincy, M.E. The first, the oldest, and in my opinion, the best of the television shows to highlight in-depth forensic investigations.   

The character of Quincy was played by Jack Klugman. The show aired on NBC from 1976 to 1983. Quincy was a Los Angeles County medical examiner who routinely mixed his forensic role with police investigatory work. He got shot at, run over, and chased, all while working forensically and solving cases in his lab and the field. He often out-policed the police.

So with respect to the late, great Jack Klugman, who also played fictional sportswriter Oscar Madison in television’s The Odd Couple (I’m not ashamed to admit that Oscar was the hero I wanted to be as a young boy), I recently spoke with an actual healthcare investigator. You can hear my discussion with Bryan Connors in the latest High Reliability podcast.

Bryan is Managing Principal Consultant at Environmental Health & Engineering in Newton, MA.  EH&E works with hospitals, laboratories, universities, and industrial facilities across the country. Bryan’s presentation at the ASHE Annual Conference, titled Successful Model for Infection Pathway Assessment: Pandemic and Future Uses, is at the core of this podcast. In our conversation, we discussed two Covid hospital case studies in which Bryan played an active role.  

The first case study involved a hospital’s rapid preparation for Covid patients and how a process known as tracer gas testing was used to verify that HVAC systems were properly configured to prevent Covid transmission.   

The second demonstrated how tracer gas testing was quickly undertaken to successfully investigate and identify the pathway of a Covid outbreak in a hospital.  

In addition to Covid, this episode of High Reliability touches on areas related to science, industrial hygiene, and hospitals, including:

On sampling: 

The most important thing if you are thinking of conducting sampling is understanding what you are trying to accomplish. Don’t sample unless you know the why. What is the objective? What does the sample mean relative to an employee or patient in the space you are sampling?

Sampling is important, but it is not as important as understanding the big picture. After sampling, much of it is observation, professional assessment, and applying the Source, Pathway, Receptor Model. We ask, can that sample be a reasonable source within the model?

On the current Covid hospital state:

We are going to have an endemic level of Covid, and hospitals and systems have adjusted to that. Variants are a big question, but we are also seeing organizations show their resiliency. 

Hospitals are in a very different situation than they were in the first two peaks of Covid. It is still an issue, but you can see the light at the end of the tunnel. Now maybe the tunnel is a bit longer than we wanted due to the new variants, but I think we will get to the end. Healthcare organizations and hospitals have shown their flexibility and resiliency. 

We discuss more, including the importance of The Interpreter, in this timely podcast.

G/MA Nuggets

Listen to the High Reliability podcast, in full here

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