A $50 million question: Where will HAI funds go?
Many IPs say money should go to HCW education
The recently finalized federal stimulus bill includes $1 billion to fund prevention and wellness programs, with $50 million going to states to implement health care-associated infection (HAI) reduction strategies. As this issue went to press, discussions still were continuing at the Department of Health and Human Services (HHS) regarding how the money will be appropriated.
"The department is continuing to consider and evaluate a series of proposals for the use of Recovery Act funds, including proposals to help fight health care-associated infections," Jennifer Buschick, spokeswoman in the HHS Office of Public Health and Science tells Hospital Infection Control & Prevention.
Some fear the funding will be lost within the health care bureaucracy before it can do any good at the grass-roots level.
"To me, getting that money out to the hospitals to let them increase their infection preventionists — increase their efforts — would be money much more well spent than having committees and a bunch of task forces get a huge amount of money to "go study" what we need to do more," says William Jarvis, MD, a former leading CDC hospital outbreak investigator now in private consulting,
The No. 1 choice of infection preventionists in a recent poll by the Association for Professionals in Infection Control and Prevention (APIC) was to invest the money in actual interventions at the facility or institutional level to reduce HAIS, says Kathy Warye, CEO of APIC. "The second choice — and I think there was only a 10 [percent] spread — was to use the money to educate other health care workers, not infection preventionists, about infection control measures," she says. "That's where the rubber meets the road in terms of whether these infections occur or not."
Indeed, as infection prevention becomes an increasingly shared responsibility, educating health care workers would seem to yield considerable bang for all those bucks. "If we really want to see these infections decline, we have to change the behavior of other health care workers," Warye says. "So, it doesn't surprise me that popped up as a very close second. In fact, they are closely aligned. Doing interventions is all about educating and working with bedside workers and frontline teams to reduce infections."
Though there is little doubt about the benefit of having an extra IP in house, she doubts the money would go to additional staffing because that would require some future ongoing, spending by the facility. The IP poll reflected that sentiment, with additional staff falling below interventions and education.
"That is a commitment over time, but for our members choosing anything over additional staff resources is a very unusual situation," Warye says. "I think this illuminates where the money could be best spent from the perspective of the people who really know how to reduce infections."
For example, there are proven models and protocols that are showing how to reduce infections in the clinical settings such as intensive care units. "We know what works but infection preventionists don't even have the meager resources that are needed to implement those," she says. "So, if we could fund those interventions through this stimulus bill, not only would we have better patient outcomes immediately, but we would have better patient outcomes over time and save millions, perhaps billions, in the entire health care system. Talk about a return on investment."
Much like Jarvis, Warye is concerned the money will never make it to the bedside level. Individual states may certainly differ on how the money should be spent, so it may go all over the place if left to local governments to allot.
"They have to have the infrastructure and the resources to do proper surveillance and provide guidance within their states to do outbreak investigations," she says. "All of that is critically important, but I certainly hope from APIC's perspective that a significant portion of that money is actually driven down to the level where the interventions actually occur and where the infections can actually be stopped."
Infection preventionists may have lost at least some of the money when the package was being put together, if not for an 11th-hour lobbying campaign by APIC. The Washington, DC-based organization reported that more than 2,000 of its members urged their representatives to include funding to help eradicate HAIs. Following a Senate compromise plan, which would have provided no funding for wellness and prevention programs or HAI prevention, APIC's members urged Congressional representatives to restore funding for these programs that had been included in an earlier House-passed bill. "We applaud the administration and Congress for retaining the $50 million in the stimulus package for HAIs," Warye says. "This is a tremendous opportunity."
The recently finalized federal stimulus bill includes $1 billion to fund prevention and wellness programs, with $50 million going to states to implement health care-associated infection (HAI) reduction strategies.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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