SHEA/APIC/IDSA/PIDS Multisociety Position Paper: Raising the Bar - Necessary Resources and Structure for Effective Healthcare Facility Infection Prevention and Control Programs

Abstract

The Society for Healthcare Epidemiology of America, the Association of Professionals in Infection Control and Epidemiology, the Infectious Diseases Society of America, and the Pediatric Infectious Diseases Society represent the core expertise regarding healthcare infection prevention and infectious diseases and have written multisociety statement for healthcare facility leaders, regulatory agencies, payors, and patients to strengthen requirements and expectations around facility infection prevention and control (IPC) programs. Based on a systematic literature search and formal consensus process, the authors advocate raising the expectations for facility IPC programs, moving to effective programs that are:

• Foundational and influential parts of the facility’s operational structure

• Resourced with the correct expertise and leadership

• Prioritized to address all potential infectious harms

This document discusses the IPC program’s leadership—a dyad model that includes both physician and infection preventionist leaders—its reporting structure, expertise, and competencies of its members, and the roles and accountability of partnering groups within the healthcare facility. The document outlines a process for identifying minimum IPC program medical director support. It applies to all types of healthcare settings except post-acute long-term care and focuses on resources for the IPC program. Long-term acute care hospital (LTACH) staffing and antimicrobial stewardship programs will be discussed in subsequent documents.

Executive Summary

Within all types of healthcare facilities, a wide array of preventable infectious risks that can lead to healthcare-associated infections (HAIs) exist. These can cause significant harm to patients, healthcare personnel, and visitors, and threaten the successful and safe operations of the healthcare facility. The facility’s Infection Prevention and Control (IPC) Program is essential to identify, mitigate, and prevent these infection-related harms, and over the past two decades, reductions in reported HAIs reflect an increased focus on HAI prevention and the requirement for facilities to systematically address these harms through their IPC programs. Despite these gains, IPC programs remain vulnerable and under-resourced, the composition of and resources committed to IPC programs vary widely, and the scope and intensity of IPC activities differ between facilities. Instead of being a foundational necessity that accommodates healthcare facilities of all types and sizes, an adequately resourced IPC program that addresses all infectious harms may be seen by some as optional and static. Given their impact on the safety, quality and operations of healthcare facilities, the expectations for facility IPC programs must be raised, moving to maximally effective programs that are foundational and influential parts of the facility’s operational structure, resourced with the correct expertise and leadership, and prioritized to address all potential infectious harms. This position paper from leading infection prevention and infectious disease societies outlines a call to action for healthcare facility leaders, IPC program members, and regulatory agencies. The role and impact of IPC programs, the components of IPC programs that are necessary to move from active to also being highly effective, and strategies to build towards a more effective IPC program are discussed.

For more information, please visit the Infection Control & Hospital Epidemiology Journal.