Prestigious panel defining essential IC elements
Panel’s findings may bolster administrative support
Amid the ongoing restructuring of the national health care industry, a timely report from a prestigious panel will soon 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. The idea is not only to have input from such representatives, but endorsement of the consensus findings by all the member organizations, says Scheckler.
"There have been publications from the CDC, APIC, and the AHA [but] no specific guideline for this," Scheckler 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, as the panel is called, 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." he says. "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."
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 a section on 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," he says. "And what it requires to do that in terms of tools and resources."
The findings could lead to enhanced support for infection control as ICPs compare the recommended infrastructure with their current programs, says panel member Candace Friedman, BS, 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]."
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 in the long term there is concern that most infection control departments are overhead’ since they are not generating revenue. To have this kind of support a document to go to is very important."
Indeed, questions addressing such infection control program concerns were asked on the 1997 Hospital Infection Control reader survey. 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. (See chart, above.) Still, when asked how their department budget was faring under current economic conditions at their facilities, 53% answered "good" and 8% "excellent." Overall, 36% of respondents said they were being advised in budget meetings that they may have to make cuts in their programs.
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