Bottom Up, Top Down

Maureen Larkin, for HealthLeaders Media, June 19, 2008

Sixteen percent of infection control practitioners say they don’t have the support they need from clinical and administrative leaders to introduce additional MRSA prevention programs at their facilities, and 14% say they aren’t given the resources to fight the hospital acquired infection.

Healthcare leaders, what are you waiting for?

Controlling MRSA is not only an issue of patient safety, but come October, it will be an issue of your hospital’s financial well being. CMS, state Medicare programs, and some private payers have already said they’re not going to cough up the funds to pay for hospital acquired infections after October. MRSA is one of them, and if patients acquire it while at your hospital, the cost of eradicating the infection will now fall on your shoulders.

Yet, in a report released by the Association for Professionals and Infection Control & Epidemiology last week, 54% of ICPs surveyed say their hospitals aren’t doing everything they can to prevent the spread of MRSA. When asked what their hospitals should be doing to strengthen infection control, most respondents said hire more staff and adopt better technology to monitor the presence of infection in patients.

Now, not every hospital has the funds to hire more staff members and purchase new technology, but every hospital has a leader, and if that leader is a champion for an infection-free hospital, his or her employees will be as well. While more staff and better technology may be desirable, a powerful, respected leader can do more.

Marcia Patrick, RN, MSN, infection control director at MultiCare Health System in Tacoma, WA, says the support she gets from her CEO is critical to the organization’s infection control success. The CEO keeps herself informed about what’s going on on the hospital floors and makes sure employees know this, too.

“Any unit, on a monthly basis, that does not meet our 90% hand hygiene goal gets a call from the CEO asking them to explain why their hand hygiene is below 90%,” Patrick says.

No one wants to get that call from the CEO, she says, and the possibility is enough to spur employees at all levels to make improvements. Even with the organization’s success, its employees continue to work on ways to eliminate the spread of MRSA. “It has to come from the bottom up and the top down,” she says. “Not one or the other.”

Leaders’ involvement in quality improvement efforts is a topic that I’ve covered quite a bit over the last few months, and it’s a topic that should be of high concern to leaders across the country as CMS’ reimbursement policies change this fall. But the APIC’s study results show that we’ve got a ways to go yet. Is a culture of infection control running through your hospital’s veins? If not, what are you, as a quality leader, going to do about it?

Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at
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