Pharmacy OneSource Blog

How to Win the Uphill Battle of Infection Prevention in Your Hospital

Posted on 07/09/15

Uphill_Battle_Blog

Infection prevention and control (IPC) programs can help reduce the number of healthcare-associated infections (HAIs) in a hospital, enhance patient safety, improve outcomes and save lives, but these programs still need to prove their value in order to receive sufficient funding to operate at a high-performing level. If you face an uphill battle to gain support for your infection prevention program in a tight economic environment, consider framing your case in monetary terms.

A robust IPC program can save a hospital money in several ways:

Securing appropriate reimbursement for patient care expenses: HAIs are expensive. A central line-associated bloodstream infection, for instance, costs about $46,000 on average and ventilator-associated pneumonia averages more than $40,000 per case.1 The Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for these preventable HAIs and many private insurers have followed suit, meaning that hospitals must absorb the costs associated with these infections.

The Centers for Disease Control and Prevention estimates that hospitals could avoid up to 70% of HAIs with high-performing IPC programs.2 One way to  estimate how much your hospital could save in direct expenses annually by increasing the resources devoted to an IPC program is to multiply the number of HAIs of each type by their average cost. Alternatively, you could use a conservative estimate of $27,500 per bed.3

  • Decrease pharmacy expenditures: A strong IPC  program can also help to reduce pharmacy costs. Beyond the decrease in costs of care associated with fewer infections, many IPC programs that use electronic surveillance systems with clinical decision support may also see pharmacy costs decline because providers initiate treatment earlier in the course of an infection and start patients on an effective, narrow spectrum medication rather than using a more expensive broad spectrum medication. Clinical decision support at the point of care leads to selection of more appropriate dosages and duration, reducing the direct costs associated with unnecessary treatment as well as the indirect costs associated with side effects.

    In addition, the Centers for Disease Control and Prevention (CDC) estimates that up to 50% of antibiotic usage in hospitals is unnecessary or otherwise inappropriate.4 You could get a conservative estimate of pharmacy cost savings by reviewing the medications, dosages and durations used to treat HAIs in your hospital and comparing them to recommended agents and therapeutic courses for the specific infections. This number will not include antimicrobial costs for prescriptions not supported by identified infections.
  • Avoided reimbursement penalties: In 2014, CMS cut reimbursement rates to 724 hospitals that were in the bottom quarter of U.S. hospitals in terms of HAI rates. Last year, the amount at risk was 1%. This year, this percentage rose to 5.5% for HAIs and other related quality measures.5,6,7 If your hospital was in the bottom half last year, you are at risk of dropping into the penalized quarter.

  • Reputation protection: High-performing IPC programs can reduce other, less easily measured costs—such as damage to a hospital’s reputation. As hospital HAI rates are now visible to concerned consumers on the CMS Hospital Compare website, high rates may result in loss of patients and revenue. With patients and payers increasingly focused on quality and safety metrics, reducing HAIs has become an imperative for hospitals.

Once you have a good sense of how much money an enhanced IPC program can save (or save from cost avoidance) for your hospital, you can put together a strong case to increase support for your IPC program.

How have you increased support for your infection prevention and control program?

 

  1. Zimlichman E, Henderson D, Tamir O, Franz C, Song P, Yamin CK, Keohane C, Denham CR, Bates DW. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med. 2013 Dec 9-23;173(22):2039-46.

  2. Scott RD. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. CDC. March 2009.

  3. Snydor ERM, Perl TM. Hospital Epidemiology and Infection Control in Acute-Care Settings. Clin Microbiol Rev. 2011 January;24(1):141-173.

  4. Fridkin SK, Baggs J, Fagan R, et al. Vital Signs: Improving Antibiotic Use among Hospitalized Patients. MMWR. Morbidity and Mortality Weekly Report. 2014;63.

  5. Hospital Acquired Condition (HAC) Reduction Program. CMS.gov.

  6. Hospital Value-based Purchasing. CMS.gov.

  7. Readmissions Reduction Program. CMS.gov.


 infection prevention



Topics: Infection Prevention

About the Author

Tim McMenamin has more than 30 years of experience in the Hospital Information Technology (HIT) industry and has been an active member of HIMSS, ASHP, HFMA and other healthcare communities for many years. Leveraging emerging technologies to deliver clinical content to the point-of-care has been an area of special interest and research.