BELLINGHAM — Medicine can learn a lot from the auto industry when it comes to improving health care, a Bellingham author says.

Naida Grunden will speak at Village Books Friday about “The Pittsburgh Way to Efficient Healthcare,” which explores how Pittsburgh-area hospitals focused on efficiency to improve quality. They adapted Toyota’s workplace safety and production philosophies.

Grunden, a former Pittsburgh resident, chronicled the efforts for the Pittsburgh Regional Health Initiative and combined those stories into a book, published in November by Productivity Press.

Grunden recently spoke to The Bellingham Herald about the book.

Question: What does car manufacturing have to do with improving health care?

Grunden: “It has to do with the removal of waste and the removal of error. (Former U.S. Treasury Secretary and cofounder of the Pittsburgh Regional Health Initiative) Paul O’Neill said that half of every health-care dollar goes up in the form of waste. Think of the opportunity that represents — an opportunity to gain about half of what we’re spending to go that much further. We must eliminate waste to improve efficiency and reduce error. … This offers the hope of improving quality and lowering costs.”

Q: Why is it important for patients to know about hospital management?

Grunden: “It will help them be better advocates for their health. You have imperfect people struggling with very imperfect systems. Anytime you add a set of eyes or ears that can find or prevent an error, it’s a good thing.”

Q: What have you learned about the control of methicillinresistant Staphylococcus aureus and other drug-resistant bacterial infections?

Grunden: “The Centers for Disease Control hand hygiene guidelines say soap and water hand washing are always preferred if hands are visibly dirty, you’ve been in contact with bodily fluids or if you’ve been to the bathroom. Otherwise, for all routine hand cleansing between procedures, alcohol hand rub is preferred (because it kills bacteria from unsoiled hands more effectively than plain soap and water).

“First of all, standardized procedures are really essential. The (Pittsburgh) VA , throughout the hospital, everyone who walks in and walks out of a patient’s room must use the alcohol hand sanitizer for no other reason than to establish the practice. And they’ve watched their MRSA rates steadily decline. It resided in making it easy to do the right thing and hard to do the wrong thing.

“It puzzles and saddens me public health officials haven’t jumped right on and invited all the gyms, day-care centers, aquatic centers, every institution, every bar and restaurant in the community to install alcohol-based hand sanitizer on the premises.”

Question: Is “zero infections” an attainable goal?

Grunden: “O’Neill’s contribution was ‘Don’t ever aim for anything less than perfection. You’ll never get that if you don’t aim for it.’ … When one (Pittsburgh- area) physician decided he wanted (central line infections) to be gone and decided to aim for that zero goal, the unit achieved it within 90 days. It became how work was done. One cardiac care unit went 15 months with zero (central line) infections. … Before, it was seven or eight in a month. People would consider it a sad reality of complex care in a big hospital. Once they stopped accepting it as unavoidable, everyone in the hospital mobilized. They had weekly ‘bug’ meetings. After they didn’t have any central line infections to talk about, they started talking about MRSA and other infectious things.”