Infection Control

HHS plans to use $50 million to prevent infections

Briefings on Infection Control, July 1, 2009

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Although we’ve yet to see whether the $787 billion economic stimulus package passed by Congress in February will have a positive effect on banks or the housing market, it is likely that $50 million of that package will directly affect IPs.

During his April 1 testimony before the U.S. House Appropriations Committee, Don Wright, MD, MPH, principal deputy assistant secretary for health at the U.S. Department of Health and Human Services (HHS), stated that HHS will receive $50 million through the American Recovery and Reinvestment Act of 2009 to fund IP efforts in hospitals, ambulatory surgery centers (ASC), and other healthcare facilities.

“Broad implementation of prevention guidelines can result in reductions in healthcare-associated infections [HAI], which will save lives and reduce suffering,” Wright said in his statement. “The growing demands on the healthcare system, coupled with concerns of antimicrobial-resistant pathogens and rising healthcare costs, reinforce the imperative to address this issue.”

This announcement came after a February report from the U.S. Government Accountability Office (GAO) stating that HHS needed to take action to collect data on ASC risks. A March 2008 GAO report urged HHS to centralize its coordination of IP activities to better allocate resources and achieve consistency in data collection.

Following the money trail
Wright said that $40 million will go toward the HHS Action Plan to Prevent Healthcare-Associated Infections, which debuted earlier this year and focuses specifically on ways to prevent surgical site infections, central line–associated bloodstream infections, ventilator-associated pneumonia, catheter-associated urinary tract infections, and C. diff and MRSA.

The remaining $10 million will be used by the Centers for Medicare & Medicaid Services to initiate a new IC survey instrument for ASC inspections, Wright said.

“Inspections have proven to be potent deterrents to relaxed infection control practices and, thus, have much potential for preventing healthcare-associated infections,” Wright testified.

Specifically, the money will allow each state to hire one to four additional surveyors, depending on ASC growth. This will allow for more inspections, at the rate of approximately once every three to four years, rather than once every 10 to 14 years, Wright said.

“As care has exploded in outpatient settings, oversight of these facilities has not kept pace,” Wright said in his testimony. “If ambulatory surgical centers or any other healthcare provider compromises on the fundamentals of safe practices, such as safe delivery of injections and medications, patients will suffer the consequences.”

This additional oversight should help mitigate the basic IC problems that ASCs have seen over the past decade (see “Ambulatory surgery centers face IC crackdown” on p. 5), including safe injection practices and sterilization, says Kathy Warye, CEO of APIC in Washington, DC.

“It doesn’t get any simpler than [safe injection practices], and these clinics have broken that basic practice, primarily by reusing syringes,” Warye says. “So what that tells us is there is a desperate need for additional education, awareness, and additional oversight. So we are very pleased to see the $10 million allocated specifically to ambulatory care, and we stand ready to help in that area.”

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