The devastating and unpredictable impact of the 2017-2018 flu season serves as a reminder and another warning to America’s healthcare system about the critical importance of infection prevention and healthcare epidemiology, and the role they play in protecting us from serious outbreaks.
The severity of the most recent flu season rivaled the levels normally seen when an altogether new virus emerges. The Centers for Disease Control and Prevention reported flu levels as high as the peak of the 2008-09 H1N1 pandemic. This flu season thousands of vulnerable adults and children were infected and millions of Americans were sickened. The lives of thousands of adults and at least 114 children were claimed by the flu.
The H1N1 outbreak exposed the vulnerability of hospitals and health systems that were not adequately prepared. The flu was an overwhelming drain on resources, with many facilities at times losing more than half their workforce to the flu--just as health centers were becoming flooded with flu patients.
Twenty years ago, our organizations—the Society for Healthcare Epidemiology of America and the Association for Professionals in Infection Control and Epidemiology--published a consensus report on the urgency of improving infection prevention and control and healthcare epidemiology programs. Today, the relentless pace of new challenges and changes—biological, technological, regulatory and systemic--gives even greater immediacy to the crucial role played by infection preventionists and healthcare epidemiologists in optimizing safety in healthcare.
An unforeseen series of biological events—the unprecedented proliferation of healthcare-associated infections such as C. difficile, worsened by the use of anti-virals to treat certain flu strains and the use of antibiotics to treat complications of flu, such as methicillin-resistant Staphylococcus aureus (MRSA) pneumonia; the ongoing rapid emergence of multidrug-resistant organisms; the attacks of new and emerging pathogens such as SARS, MERS and Ebola; and even the rise of bioterrorism—have placed staggering demands on infection prevention programs.
Exacerbating these threats, unexpected shortages and a critical lack of novel antibiotics have heightened the danger. Moreover, new legislative and administrative mandates, public reporting, pay-for-performance and payment penalties have further strained health systems and IPC/HE programs at a time when their services are more vital than ever.
All health professionals concerned with patient safety and quality care share a common goal of creating a safer world by preventing infections and the spread of antibiotic resistance. The fundamental question for healthcare leaders is how institutions can most effectively leverage infection preventionists and healthcare epidemiologists to implement strategies that eliminate preventable infections, while also maintaining fiscal responsibility.
There is no question that additional resources in infection prevention are necessary. The work of infection preventionists and healthcare epidemiologists has expanded exponentially over the past two decades, increasing workloads, demands and threats—without commitment of additional resources. Increased investment is crucial to enable IPC programs, and the hospitals they work within, to have a fighting chance to respond quickly and effectively to an ever-increasing variety of threats.
But this is not simply a question of money. Nor can we just “check the box” by filling staff positions to meet regulatory requirements. Healthcare leaders must be strongly committed to proactively creating a heightened consciousness—for every employee from frontline professionals to environmental services—that infection prevention and control is everyone’s responsibility and is critical for patient and employee safety.
Creating a true culture of safety requires building strong infection prevention and healthcare epidemiology programs. Real preparedness necessitates investment to build the infrastructure necessary to prevent and control outbreaks and save lives, while also curbing potential increased costs associated with healthcare-associated infections.
A fully trained workforce is the critical line of defense for infection risks. The foundation for patient and healthcare worker safety requires institutional backing of infection prevention and antibiotic stewardship strategies. This institutional support from hospital leadership is needed for an organization to develop deeply ingrained commitment to best practices, such as hand hygiene, that extend throughout the entire patient care process including preparedness for emerging threats.
Infection preventionists and healthcare epidemiologists bring deep foundational knowledge of best practices as well as emerging threats. However, these professionals must be empowered by institutional leadership to spur necessary practice changes to spread their expertise and promote a culture of patient safety throughout the hospital so patient care and quality can be optimized.
How prepared is your institution for the next outbreak, epidemic, or even another bad flu season? Before answering, we recommend taking a hard look at your infection prevention and control program and finding out if it is well resourced and supported. Remember that an ounce of prevention is worth a pound of cure.
Author bios:
Eve Humphreys, MBA, is Executive Director of the Society for Healthcare Epidemiology of America. Humphreys was appointed to this role by the SHEA Board of Trustees in 2013. Prior to SHEA, she served as Senior Director of Membership at the American Academy of Otolaryngology-Head and Neck Surgery.
Katrina Crist, MBA, is CEO of the Association for Professionals in Infection Control and Epidemiology. Katrina APIC as chief executive officer in June of 2011. She was instrumental in developing the APIC Strategic Plan 2020 to organize the association’s mission and goals around a plan to advance toward healthcare without infection.