Elevators and Nosocomial infections

Nosocomial infections are infections that patients contract inside of a hospital, due to contamination or germs present there. A patient undergoing treatment at a hospital is almost always has a weak immune system, which is more susceptible to infection. And the odds of contracting an infection are higher in operation theatres and ICUs. Most likely because those needing to be in the ICU or get operated are in a far more immunocompromised state.

Now ordinarily hospitals are brilliant at spotting and solving hospital related risks and challenges. Having been an examiner for a prestigious award that company, hospital and educational institute teams compete for in areas of innovation and improvement, I have seen the top projects being showcased, and they are impressive. The meticulous tracking and calculating of various data points, identifying causes, finding and implementing solutions, and tracking effectiveness, and then setting up a cycle for continuous improvement.

So it is concerning when nosocomial infections account for 5-10% of all patients in an acute care hospital in the US [+]. And the numbers are even more concerning in India, where our hospitals are far more crowded, with little concern or respect for regulation. Here in India, nosocomial infections are as high as 11-60% in ICUs [+].

While this one is quite obvious, assuming ICU cleanliness follows the highest of standards and procedure, I think a bulk of these infections occur in elevators. Elevators are known to be extremely contaminated, the buttons in particular.

While I unfortunately don’t have a broad solution idea to offer for this challenge, I do have some almost obvious suggestions:

  • If a new private hospital is being constructed, try and create an isolated elevator between ICUs and operation theatres. Often, patients are carried for surgery in common elevators, exposing them to every visitor who might have visited someone with another infection, which they are likely to catch
  • Again, for new hospitals yet to be constructed, ideally have the wards frequently visited by visitors on the lower floors, and have sloped ramps for people to walk up and down to those floors (say up to second floor). That way, a bulk of the visitors who would ordinarily use the elevators could be saved, thus perhaps making it economical to dedicate at least one elevator purely for shuttling only patients between  ICU and/or operation theatres.
  • A shield-type enclosure (might look like the mosquito nets for beds) over the patient’s trolley while being moved might help contain their infections and reduce spread while in the elevator
  • Limited options for public hospitals or those with limited budgets, seem to include:
    • stricter laws for visitors,
    • encouraging the use of staircases by visitors,
    • installing affordable disinfection tunnels, and making masks compulsory for visitors

This concern was part of an initiative called RattL ’em.
What is RattL ’em?: We are constantly fascinated by companies, products and services.
So, every few days, we send out an email to, or share an idea online about a random company anywhere in the world that caught our fancy. What we share is either an idea for a new product or service, a concern area to focus on, or a new feature or improvement to their portfolio.
We do it for free. And for fun. And the company that receives it is free to use the idea, with no financial or other obligation toward us. We think of it as our way to be the best at what we do in the field of innovation and design strategy consulting.

  1. Swati

    Innovative ideas , really hospitals need to think over it.

    • Shrutin N Shetty

      Thanks, Swati! Don’t know if it is the cause, and if those suggestions will help, but I think they might.

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