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Would hospitals with relatively poor infection control practices benefit from knowing that their operations might be subject to inspection at any time? Washington state seems to think so and will begin conducting surprise inspections at Washington hospitals at least once every 18 months to check on compliance with infection control standards and other patient safety guidelines. Previously, hospitals were given four weeks' notice to prepare for such inspections and may have used this time to temporarily increase staffing and improve sanitation, reports The Seattle Times.

Surprise inspections should encourage hospitals to consistently adhere to good infection control practices. With hospital operations subject to unannounced inspection, hospitals will more likely strive to meet infection control standards over the long term, rather than give the illusion of meeting these standards for a brief time around scheduled inspections. If a main barrier to hospitals improving their performance in infection control is that hospitals believe underperformance isn't going to be noticed and called out, then this new approach may be particularly effective at getting hospitals to implement better infection control practices.

Whether constant fear of inspection adequately incentivizes hospital improvement remains to be seen, but certainly the effects of this new inspection policy are worth following. Even if for some reason hospitals do not respond to this policy by constructively improving their practices, as long as inspections are conducted thoroughly, health officials should at least have a better idea of which hospitals perform relatively well and which perform poorly. Text of the Washington state law requiring unannounced hospital inspections is available here.