This episode is part of our in-depth coverage of the Healthcare Infection Transmission Systems Consortium (HITS) 2018 conference in Nashville, TN that took place September 18-20th. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.

Adapted from Jason “The Germ Guy” Tetro’s Opening Keynote at HITS 2018

Have you ever written the perfect checklist? You left no stone unturned and accounted for every possible step that needed to occur. You trained your staff. Everyone understood and was on board. But you still failed.

Today’s guest would tell you that you failed because you took a systematic approach when you really needed a systems approach.

A systematic approach takes all the facts into consideration and manifests itself as guidelines, a checklist or standard operating procedure (SOP). It’s based in science and best practice. On paper, it makes all the sense in the world.

A systems approach considers much more. How does your guideline fit in with the culture of those that will carry it out? Forget whether or not they’ll believe it. The question is, will they follow it?  A systems approach requires empathy. It works because it shows people that there’s a place for them, and they’re culture, within the systematics and steps they need to carry out.

This may sound hokey to you. You may shout: “I’m not going to pander to peoples’ feelings! I have a business to run!” But you do so at your own peril. You can write your guidelines, checklists and standard operating procedures until you’re blue in the face. But if people won’t follow them, then you’ve wasted your time. This, as we like to say on the show, is called confronting reality.

On this episode, we’re talking with Jason Tetro. He’s the microbiologist, author and thought leader better known as The Germ Guy! We recorded this episode live at the Healthcare Infection Transmission Systems Consortium (HITS) 2018 conference in Nashville, TN where Jason was the opening keynote. In his talk there, Jason explained to us why a systematic approach often falls short in the real world, and why an empathic systems approach may be better suited to help you get your job done.

This conversation fits the premise of The #HCBiz Show! as well as any we’ve done to date. Jason’s common sense approach to confronting reality in the healthcare system takes us down interesting paths including the patient workflow (yup… they have one), blockchain, gamification, and even Eminem’s song, Lose Yourself. This is good stuff. I promise you’ll gain a brand new perspective on a thing or two.

Here are some highlights:

0:50 The Germ Guy’s journey from the lab to the TV.

3:37 Fixing the public’s dysfunctional relationship with microbes.

7:44 Keynote – Systematic vs Systems approach to infection control. The Systematic approach is following the guidance documents and standard operating procedures. The Systems approach takes a universal perspective on how to achieve a goal and, through a multifactorial approach, uses current systems to achieve that goal. It all comes down to empathy.

13:39 Empathy is when the system shows you that there is a place for you and your culture.  If it’s right on paper but wrong in the real world, you need to confront the reality you’re dealing with and allow the workforce to participate the way they need to.

15:05 Innovation, culture, empowerment. When you forget about those 3 things you’re taking away your own capacity to make a difference. Don’t just follow rules and regulations if you know there is more that could be done. This must be a democratized system that hears all 20 different components to good infection control.

19:48 Quality measures are too distanced from the patient. There is too much bureaucracy in the way to remember the actual purpose of your actions.

20:55 Blockchain could be the potential link between systems and systematic approaches. What if human activities could be viewed as transactions in real time? You can find a way to develop transactional steps between SOPs to see the most common mistakes and fix the system.

24:20 Tokens and gamification of healthcare. The token can be used as proof of actions or accomplishments that can be used for checkpoints or rewards.

27:15 Physician workflow and the patient journey. What can we do within an existing workflow? How do we collect data while doctors are doing normal tasks without interrupting? Include the patient in providing info that will make doctor’s jobs easier.

29:18 Examples of infection prevention and the simple but effective parking idea to make visitors wash their hands.

31:20 Robust checklists can shut off your creativity and problem-solving skills but we know they can be helpful. Where is the line? Checklists work until the parameters around checklist have changed.

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This episode was recorded on site at the HITS 2018 conference in Nashville, TN. Check out all our HITS 2018 episodes here, and look for more throughout the month of October.

Thank you to HITS, Christine Greene of NSF International, Kelly Reynolds of the University of Arizona and Michael Diamond of The Infection Prevention Strategy for working with us on this conference coverage. It was a great event, in a great city, attended by true heroes of Infection Prevention and Control from all over the world.

Be sure to check out the next HITS conference in August 2019 in Buffalo, NY!

About The HITS 2018 Conference

The HITS 2018 Conference was held on September 18-20th in Nashville, TN.   HITS 2018 offers a unique forum for the exchange of knowledge and experience in the prevention of healthcare-associated infections and promoting “hospital health”.  The 2018 HITS “Catalyst for Change” Conference is a working conference, bringing together research scientists, industry and healthcare professionals for an interdisciplinary and dynamic approach. We work together to understand and prevent the transmission of pathogens throughout the hospital facility through a collaborative effort that includes engaging in applied research.  The conference is accredited as a provider for continuing education units (CEUs) through National Environmental Health Association (NEHA) and National Board of Public Health Examiners (NBPHE). Join us for this one-of-a-kind, multimodal event where researchers and experts from across disciplines will work toward identifying research gaps and applying data-driven methods in the field. Meet, greet and share ideas with the individuals and organizations who are growing and sustaining the industry as we explore creative and innovative solutions to this global problem. The full 2018 schedule can be found at

The HITS organizing committee has assembled world experts and key opinion leaders to share their knowledge and expertise. We host a research poster session to hear from those in healthcare about the research being conducted in their facilities.  We also incorporate workshop breakout sessions each day in order to provide a unique forum through which everyone can interact and be innovative as we work to identify potential solutions to key barriers and develop an agenda for change moving forward into the next year.  After the conference, members have the opportunity to become involved in one of the many research workgroups conducting research around pathogen transmission in healthcare.

Check out highlights from the HITS 2017 conference:

For media inquiries:

For more information, please visit the HITS Consortium website: or email us:

Checkout our conference preview episode: HITS 2018 A Catalyst for Change in Infection Control – Episode 67 w/ Dr. Christine Greene and Dr. Kelly Reynolds.

About Jason Tetro

Jason Tetro is a visiting scientist at the University of Guelph and has over 25 years of experience in health-related microbiology and immunology. He has worked in numerous fields including bloodborne, food and water pathogens; environmental microbiology; disinfection and antisepsis; and emerging pathogens. In the public, he is better known as The Germ Guy.  He regularly writes for The Huffington Post Canada and is a regular with media outlets worldwide. He has written two books, The Germ Code, which was shortlisted as Science Book of The Year (2014) and The Germ Files, which spent several weeks on the national bestseller list. Jason is an advisory board member of

@JATetro on Twitter

The Germ Code

From the book’s description: Since the dawn of the human race, germs have been making us sick. Whether the ailment is a cold, the flu, diabetes, obesity or certain cancers, the likely cause is germs. Our ancient enemies have four families – bacteria, viruses, fungi, and protozoa – and many names: Ebola, E. coli, salmonella, norovirus, gonorrhea. . . Human beings are engaged in a “war on germs,” in which we develop ever-more sophisticated weapons and defensive strategies. But it is a war we can never win. Our best plan for staying as healthy is to choose our battles carefully, and try to co-exist with germs as best we can.

The Germ Code is a wise, witty and wonderfully readable guide to our relationship with these infinitesimal but infinitely powerful creatures. Microbiologist Jason Tetro takes us outside the lab and shows the enormous influence of germs upon humanity’s past, present and future. He unlocks the mysteries of “the germ code” to reveal how these organisms have exploited our every activity and colonized every corner of the earth. From his own research and personal experience, Tetro relates how the most recent flu pandemic happened, how others may have been averted and how more may come about if we aren’t careful. He also explains that not every germ is our foe, and offers advice on harnessing the power of good germs to stay healthy and make our planet a better place.

The Germ Code is a fascinating journey through an unseen world, an essential manual to living in harmony with germs and a life-enhancing (as well as life-saving!) good read.

The Germ Files: The Surprising Ways Microbes Can Improve Your Health and Life (and How to Protect Yourself from the Bad Ones)

From the book’s description: The microbes living on and inside us outnumber the cells in our bodies three to one. Many provide services on which our well-being, our moods, our very lives depend. They help to digest our food and operate the immune system. They trade information about potential mates when we kiss.  They alert the brain to problems in different locations around the body. The balance of their populations in our gut is a crucial factor in our physical and mental health.  

The effect of germs on our lives is not, however, a one-way street. We can help their efforts by the way we lead our lives. 

The Germ Files is a one-stop source of the most up-to-date, life-changing information on our relationship with microbes, presented in concise and highly readable items grouped by theme. Areas covered include health, hygiene, sex, 
childcare, nutrition and dieting.

The Germ Files will answer your questions about everything from preventing flu to selecting probiotics, while constantly surprising you with revelations about the miraculous workings of the microscopic world.

About the Healthcare Infection Transmission Systems (HITS) Consortium

The Healthcare Infection Transmission System Consortium is a not-for-profit organization serving the field of infection control and prevention. HITS takes a holistic perspective to targeting healthcare associated infections by including multiple disciplines in the conversation, including infection prevention, environmental services, construction and renovation, facilities management and engineering along with research scientists and industry experts. HITS focuses on the major avenues for pathogen transmission in hospitals:  hands, surfaces, water and air.  HITS provides the necessary, cross-disciplinary platform to share knowledge and engage in research regarding the prevention of healthcare-associated infections and promotion of overall hospital health.

@HITSConsortium on Twitter

HITS Consortium on LinkedIn

Related and/or Mentioned on the Show

Closing the loop: Larry King’s real name is Lawrence Harvey Zeiger.

Check out all of the #HCBiz Show! Infection Prevention and Control coverage.

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