Infection Control

Infection prevention faces budget cuts, higher expectations

Briefings on Infection Control, September 1, 2009

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There isn’t a business in the United States that hasn’t felt the brunt of the recession through layoffs, pay cuts, salary freezes, reduction in benefits, and lost revenue.

And although few in the general public might consider their local hospital a business, anyone who has seen the financial side of a healthcare facility can say business and medical care go hand in hand in most hospitals.

So when the economy slumps, so does the availability of resources for infection prevention. But you won’t see regulation slow down along with the reduction in ¬profit. Regulatory bodies such as The Joint Commission and CMS continue to expect the highest quality care, particularly from the IC department. Today IC departments are forced to meet demands with less money and fewer staff members.

A recent APIC survey released in June questioned nearly 2,000 members in late March to determine the effect the recession had on IC programs. Forty-one percent of respondents reported budget cuts in infection prevention in the previous 18 months due primarily to the economic downturn. Many faced cuts in education and staffing specifically, largely regarded as two of the most important resources in infection prevention.

Unfortunately, this is when the business side of medical care gets entwined with the clinical side, says ¬Terry Burger, director of IC at Lehigh Valley Hospital in Allentown, PA. It’s a time when the whole hospital is feeling squeezed.

“I don’t think they are targeting infection control specifically; I think they’re just trying to make ends meet,” Burger says. “Ours decided to do it in a different respect. Like we’ve had to pay more for benefits and there were some salary reductions.”

Although every unit in the hospital is affected during economic slumps, meeting IC expectations makes it particularly difficult to cut corners.

“In terms of infection control specifically, it’s very difficult to do more with less,” Burger says. “You’ve got regulatory requirements that have to be met that are nonnegotiable. That’s a challenge for those hospitals that don’t have adequate resources.”

Prioritize your responsibilities

Although IPs can argue their case to administration, if the money isn’t there, they are fighting a losing battle. In a time of depleted funds, the best bet is to bear down and find resourceful ways to meet expectations with what is available.

A major struggle expressed by IPs in APIC’s economic survey were state laws requiring public reporting of healthcare-acquired infections (HAI). Half of respondents said public reporting of HAIs makes it more difficult to focus on preventing infections.

“I think it’s a double-edged sword,” says Burger, who must report infections under Pennsylvania’s ACT 52, which requires hospitals to report infection rates. “In one respect, it sort of pushes the envelope so that there are things that aren’t negotiable. By the same token, it is so oppressive. Yes, we have the resources to meet the requirements; what it takes away from is the resources to get out there and educate and do prevention measures.”

Meeting CMS core measures, passing Joint Commission surveys, and publicly reporting infection rates are a few responsibilities that an IP cannot ignore. After those requirements are fulfilled, prioritize IC issues that will be most detrimental to your facility’s bottom line, says Donna Peace, RN, CPHQ, CIC, IP at Children’s Healthcare of Atlanta and spokesperson for APIC.

“You have to choose the highest-dollar issue, the one that is going to cost the facility the most money to focus on,” Peace says. “That’s where your quality folks can help you to determine what your highest-cost items are. But that really goes along with your infection control risk assessment.”

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Briefings on Infection Control.

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