Infection preventionists poised to lead the way
Current fires may forge future leaders
If infection preventionists can work their way out of the current wilderness of change, there is some feeling they may be poised for a leadership role in a health care system becoming painfully aware of the power of prevention. That's due in no small part to the Centers for Medicare & Medicaid Services (CMS) decision to slash reimbursement on some infectious complications.
Frustrated with the continuing annual toll of health care infections, critics have sometimes come close to labeling IPs as much a part of the problem as the solution. On the contrary, infection prevention is a science perfectly positioned to lead a broader quality revolution in health care, says Peter Pronovost, MD, PhD, medical director of the Center for Innovations in Quality Patient Care at Johns Hopkins University School of Medicine.
"To be honest with you, I think infection preventionists are years ahead of anyone else [in medicine] in looking at preventable harm," he tells Hospital Infection Control & Prevention.
it's been eight years since the Institute of Medicine's report "To Err is Human" — which in large part sparked the patient safety movement — but many medical disciplines still can not answer "are we safe enough?" he says. The infection control community can be a model "because to a large extent for some infections, they can answer the question," he says. Look at the structural and human resources that have been put into infection prevention, the use of standardized definitions and surveillance programs throughout the country, Pronovost emphasizes.
"Those are not perfect, but they are pretty darn good," he says. "There is an infrastructure for hospitals to invest in to monitor these infections and implement best practices. For other types of preventable harm — like deep venous thrombosis or decubitus ulcers — we don't have any of that. There are no definitions that are agreed upon for measuring harm from them. The CDC doesn't have an infrastructure to monitor them. Infection control is a model that I hope is expanded to other types of preventable harm. What I can see in the future is infection control experts — who know epidemiology and monitor infections in the hospital — migrating to outcome measures [in general]. They will expand their expertise to monitor a variety of other types of preventable harm."
Such a role for IPs has certainly been discussed over the years, with health care observers noting that infection preventionists have the skills to do everything from reducing patient falls to stemming the increasing tide of outbreaks in ambulatory clinics. The tipping point may be the CMS action to reduce reimbursements, a blow to the bottom line that may make a preventionist of any ilk a hot commodity. In that regard, IPs will be sufficiently preoccupied in the short term trying to show they can prevent infections — let alone other adverse outcomes. But one can dream.
If infection preventionists can work their way out of the current wilderness of change, there is some feeling they may be poised for a leadership role in a health care system becoming painfully aware of the power of prevention.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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