Panel defines essential infection control elements
Findings may bolster administrative support
Amid the ongoing restructuring of the health care system, a timely report from a prestigious panel soon will be released, defining the needed infrastructure and essential elements of a modern infection control program.
"The purpose of this is to pull together in one place the best available evidence and the best consensus on what in 1997-1998 we think the essential elements and infrastructure [of an infection control program] should be," says panel chairman William Scheckler, MD, hospital epidemiologist at St Marys Hospital Medical Center in Madison, WI. "It is filling a need that is not currently met at least in the view of the panel members by other guidelines, rules, and requirements that are out there."
The panel includes members from the Joint Commission on Accreditation of Healthcare Organizations, the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), the Society for Healthcare Epidemiology of America (SHEA), and the Centers for Disease Control and Prevention (CDC). The idea is to have input from such representatives and endorsement of consensus findings by all member organizations, he says.
"There have been publications from the CDC, APIC, and the AHA [but] no specific guideline for this," he says. "People thought that it would be everyone’s best interest to try and get the best consensus version of this down and on the record. [Infection control] is sort of the grandparent of all data-based quality improvement efforts in health care institutions."
The Consensus Panel on Infrastructure and Essential Elements of a Healthcare and Infection Control and Prevention Program is slated to release its findings in February 1998. Plans call for joint publication that month in the American Journal of Infection Control and Infection Control and Hospital Epidemiology, the journals of APIC and SHEA, respectively.
"The plan is to publish it in both journals and get the endorsement or acknowledgment of all of the organizations listed. These were all people approved by the various organizations as appropriate to be on this panel. Pretty much all of the heavy hitters are there," Scheckler says.
Focusing primarily on acute care hospitals, the report will address such topics as goals and outcomes, functions of infection control and health care epidemiology, tools and resources, and connecting links to the future, he says. "We wanted to make sure that we clarified what we meant by infection control: good data, good surveillance, and so forth, and what it requires to do that in terms of tools and resources."
The findings could lead to enhanced support for infection control as infection control professionals (ICPs) compare the recommended infrastructure with their current programs, says panel member Candace Friedman, MT(ASCP), MPH, CIC, president of APIC. "We will be developing an outline of what an ideal program should be," she says. "People who work in settings where that is applicable mainly hospitals would be able to look at this and make comparisons with their program. They could see if there are some areas that they could potentially go to their administrator and [seek funding for improvements]."
Help for the beleaguered
There has been much discussion of infection control program cutbacks in the managed care era, and the panel’s report and recommendations could prove timely for ICPs struggling to bolster department budgets.
"[Budget] cuts are being made, and infection control is part of those cuts," Friedman says. "My inference from that is not that infection control is being targeted, it’s just that reductions are being made everywhere. Outlining what a program should look like is important because long-term there is concern that most infection control departments are overhead’ since they not revenue generating. To have this kind of support a document to go to is very important."
Indeed, questions about such infection control concerns were asked in the 1997 Hospital Infection Control reader survey. (HIC is a sister publication to Healthcare Benchmarks.) For example, when asked to consider perceptions of their programs given their current level of funding and support, 22% of responding ICPs said their program was viewed as declining in importance. Still, 53% answered "good" and 8% "excellent" when asked how their department budget was faring under current economic conditions. Overall, 36% said they were being advised in budget meetings that they may have to make cuts in their programs.
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