Crouse Docs Rap to Halt HAC

Why would three distinguished hospital physician leaders including a retired 71-year-old surgeon, and two advanced practice nurses dress up like gangbangers—with dangling bling and head bandanas—and strut around risking embarrassment to themselves and their hospital?

It's for the cause, man. For the cause.

One morning while brushing his teeth, Syracuse-based Crouse Hospital senior medical quality director Mickey Lebowitz, MD, was mulling over a problem, thinking out loud.

"Like many hospitals, we sometimes face challenging situations, and we have faced a few recently," he says. He heard his voice saying "Heck No!"

"I thought, that sounds a lot like 'HAC NO!' because I had HACs (hospital acquired conditions) on my mind." Then the rhymes just kept on coming. One verse, for better or worse, led to another. When he was done, he had the lyrics to The "Crouse Hospital Germinators" rap video:

Patients come in and they are sick.
We want them to get better and do it quick.
But there are things we do that cause de-lays,
That make them worse, and that's not okay.

And another

We call these things hospital-acquired conditions
It can be caused by all, even nurses and physicians
We don't want our patients getting H. A. C.
It's bad for them, and for us financially.
So, so, so, so.
We want our complication rate to be Zer-o
Hey HAC No, Hey HAC NO.
We want our complication rate to be Zer-o.

The background music comes from a whiny synthesizer.  The setting, which looks like a parking lot, is fake.

Lebowitz, 54, an internist specializing in endocrinology, confesses that he sees himself as a "middle-aged Jewish rapper.  I like to write raps, like for parties or anniversaries."

So he cajoled two colleagues, Crouse's senior surgical quality director who is a retired surgeon, Dennis Brown, MD, 71, and Crouse's infection control medical director, Waleed Javaid, MD, 38 to get in on the act. They donned sunglasses, special Germinator t-shirts, bling, (cardboard wrapped with foil) and joined him.

They came on board without much persuasion.

They made a HAC video and put it on YouTube to show the entire staff. And they had some fun with a very serious subject.

Lebowitz and Javaid play HACs, and Brown is clostridium difficile, or "C-diff colitis."

Todd Olrich, 31, a certified medsurge nurse specialist, plays MRSA, or methicillin resistant staphylococcus aureus. And David Martin, 48, an infection prevention nurse, plays a CAUTI, catheter-associated urinary tract infection.

Lebowitz says he understands that hospital staff know how to prevent infections and adverse events, but sometimes they just forget to do every step.

"We know we have the technical components to reduce infections, but more important is engaging people to actually want to do it," he says.

Crouse, a 506-bed hospital with 2,700 employees, has indeed had a few challenges lately. The Leapfrog Group Safety Score handed them a C in November.  And for the Consumer Reports safety score issued last summer, Crouse got a 42 out of 100 points, ranking 71st out of 136 hospitals in New York that were rated, which is below the middle of the pack.

The video also served to boost morale as the hospital motivates its staff to improve in all categories.

"If you look at our control charts over the last several years, everything's getting better," Lebowitz says.  "Our CAUTIs, CLABSIs, and C. diff rates are trending better. We are moving in the right direction."

Lebowitz says he was concerned "about how my physician peers would react" to such a thing.  "They're a serious group of people, and I thought they might say, 'Mickey, why areyou doing this? We have to be taking care of patients.'

"I thought I was going to get some negative feedback, but it's just been just the opposite."

"Instead, they've come up and slapped me on the back. They've said, 'we really needed that injection of fun. And we love the message.' "

As a hospital official these days who is not in private practice, Lebowitz spends time walking the halls of the hospital as a liaison between staff and administration. "And I can't tell you how many people have come up to me and said "Hey, HAC-NO. I can't get that jingle out of my mind."

But the video personality "who gets the most kudos," Lebowitz says, "is our Dr. Brown—our C. Diff. People just love seeing him out there, a 70ish retired surgeon, rapping about HACs."

Brown joined in because he has a particularly keen interest in preventing surgical site infections and venous thromboembolism in the surgery population.

Wasn't there anyone who thought this was inappropriate, I asked Lebowitz?

To be honest, yes, he replied. There was one guy who thought it was stupid. "Sam Liebowitz. My son.  He said, 'Daaaaad. What are you doing? You are not a rapper!'"

Another video is in the works and will be ready later this month.

The Association of Professionals in Infection Control and Epidemiology is now accepting YouTube videos from hospital teams for its third annual contest. 

See Also:
Videos Go 'Viral' in Fight Against HAIs