Ensuring sufficient resources to implement and maintain a high-performing infection prevention and control (IPC) program requires gaining support from all critical stakeholders, including representation from executive leadership. As an infection preventionist,whose support do you need to enlist and what do they need to know?
Start with likely infection prevention team members, if you’re beginning to implement your program, or start with current members if you have an established program. Ideally, your IPC team will have support from an infectious disease physician. You will also need to engage other members of the IPC team, including a microbiologist, information technology, and a data analyst (if applicable). The success of any infection prevention program depends on support from the medical staff and other healthcare providers. The IPC stakeholders must persuade other clinicians of the importance of infection prevention and the need to adopt evidence-based best practices.
Points to communicate: About 722,000 healthcare-associated infections occur annually in U.S. hospitals, leading to the deaths of 75,000 patients each year.1 Multidrug resistant organisms cause an increasing number of these infections, a problem compounded by poor antimicrobial stewardship in hospitals. The Centers for Disease Control and Prevention estimates that up to 50% of antibiotic use in acute care hospitals is inappropriate.2
Involve others with aligned goals. This may include members of the antimicrobial stewardship program team, other pharmacists and members of the hospital’s quality assurance and patient safety teams. These individuals have a role in building an effective infection prevention program and may have ongoing or planned educational programs, initiatives or needs that dovetail with those of the IPC program. By working together, you can achieve greater impact and extend scarce resources, including funds and physician focus.
Points to communicate: About 1 in 25 hospital patients experiences at least one healthcare-associated infection (HAI). Hospitals that implement high-performing IPC programs report up to 68% reductions in certain HAIs.3
Find a champion in administration. The chief medical officer may have a particular interest in multidrug-resistant organisms or the chief financial officer may focus on the need to avoid reimbursement penalties associated with high rates of healthcare-associated infections. A business case in support of establishing or increasing funding for infection prevention should include points likely to sway administrators with clinical, financial or reputational concerns. It should also have a budget that addresses needs for compensation of professionals for time spent on infection prevention and the infrastructure required to perform surveillance, education and training.4,5
Points to communicate: The Centers for Medicare and Medicaid Services (CMS) significantly increased reporting requirements in 2015. Acute care hospitals must now report central-line associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) from all adult and pediatric medical, surgical, and medical/surgical wards, in addition to the ongoing reporting from intensive care units. In addition, CMS surveyors now use a 49-page survey to evaluate hospitals’ compliance with infection prevention-related Conditions of Participation.6 As of this year, up to 5.5% of a hospital’s Medicare reimbursement could be at risk for failure to reduce HAIs, readmissions and other quality measures, with 1% tied to CLABSI, CAUTI and patient safety indicator rates.7,8,9,10
How have you encourage stakeholder support for your infection prevention program?
Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G et al. MultiState Point-Prevalence Survey of Healthcare-Associated Infections. N Engl J Med 2014;370:1198-208.
Fridkin SK, Baggs J, Fagan R, et al. Vital Signs: Improving Antibiotic Use among Hospitalized Patients. MMWR. Morbidity and Mortality Weekly Report. 2014;63.
Preventing Healthcare-Associated Infections. CDC At Work.
Health care facilities--Setting up an infection control program. ReAct--Action on Antibiotic Resistance. Uppsala University, Sweden.
World Health Organization. Core components for infection prevention and control programmes – Report of the Second Meeting of the Informal Network on Infection Prevention and Control in Health Care [Internet]. World Health Organization; 2008.
Centers for Medicare & Medicaid Services. Hospital Infection Control Worksheet.
Hospital Acquired Condition (HAC) Reduction Program. CMS.gov.
Hospital Value-based Purchasing. CMS.gov.
Readmissions Reduction Program. CMS.gov.
- Understanding the Hospital-Acquired Condition Reduction Program. Quality Improvement Organizations. The Lake Superior Quality Innovation Network/Centers for Medicare & Medicaid Services.