“It’s not in the budget.”

1915_Burroughs_Adding_Machine_Ad_OM

“An ounce of prevention is worth a pound of cure.” -Benjamin Franklin

Despite the truth in the above adage, with a few exceptions (vaccines being one of the few) preventative measures are not prioritized in healthcare in favour of fast-acting cures.  This is true of mental health, cardiac health and particularly infection prevention, which ironically has the word in its very name.

Why? We think it may largely be because financial constraints make it difficult for them.  For example, budgets (and the strategies that are funded by them), whether government, or business, or healthcare are typically done up on a year-by-year basis.  Spending on prevention looks bad on today’s budget if it doesn’t start to pay off until seven years from now, so we by and far tend not to.

How do we fix this?

We suggest that the insurance industry get involved.  Offer incentives to hospitals and other facilities with proper infection prevention equipment and signage.  Hike premiums on those that are not up to par.  Incentivize safety!

This isn’t a new concept.  It’s already used in the following fields: road safety (new drivers take a hike unless they take classes), fire safety (business insurance is higher when working with flammable substances), and home ownership (the presence of a burglar alarm will lower your premiums).

We’re not talking about making sure that hospitals keep a good stock of gloves on hand – that’s not prevention in the way we mean it, that’s just keeping supplies up-to-date and is already quite well funded.

We’re talking honest-to-goodness public health promotion through transparent and consistent communications such as carefully-controlled signage, standardized safety symbols and a comprehensive public-facing campaign. On top of this, all these need to be in sync – such a protocol needs to ensure that everything is up to spec and nothing falls behind.  This is how road safety does it, and it’s worked out pretty well so far.

Things like these fall through the budget gaps, and it’s unfortunate because it’s preventing our health system from taking the steps towards a preventative, truly patient-centric and ultimately money saving model.  Simply because then it would make this year’s budget (and this year’s hospital CEO!) look bad.

EDIT: The World Health Organization has looked at various (sometimes more immediate!) cost-savings related to hand hygiene promotion alone.  You can find it here starting on page 168.

(image credit: http://commons.wikimedia.org/wiki/File:1915_Burroughs_Adding_Machine_Ad_OM.jpg Licensed CC-BY)

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