Making a Business Case for Infection Preventionists
By Christopher Cheney
Infection preventionists have an expertise that is different from physicians and nurses.
They are trained in hospital epidemiology as well as sterilization and disinfection of reusable medical instruments, and they are valuable members of a CMO’s clinical care staff.
An infection prevention and control executive at Boston Children’s Hospital recently made a business case for hiring more infection preventionists and was able to gain approval to increase staffing by more than 50%.
“Infection preventionists add a lot of value,” says Jennifer Ormsby, DNP, RN, senior director of infection prevention and control at Boston Children’s Hospital. “They have an expertise that is very different from a nurse or a physician. They can improve patient safety and patient care.”
Infection prevention and control programs at healthcare organizations are often understaffed, according to Ormsby.
“Nationally, infection prevention teams are understaffed,” Ormsby says, “and the Association for Professionals in Infection Control and Epidemiology and infection preventionists across the country have been advocating post-COVID for C-Suite leaders to have more infection preventionists in their healthcare facilities.”
At Boston Children’s Hospital, there was a shortage of infection preventionists in ambulatory and procedural settings, and Ormsby led an effort to build a business case for increased staffing.
Ormsby took a data-driven approach to building a business case for more infection preventionists. The process started with an assessment of the current state of the hospital’s infection prevention and control program, including hospital-acquired infection rates as well as process measures such as hand hygiene, personal protective equipment audits, and the most recent accreditation survey results.
“I was able to present our current state, a bridge to the right size for our department, and right-sizing for our enterprise,” Ormsby says.
Part of the business case was detailing overtime payments to the existing infection preventionist staff. According to Ormsby, the hospital was paying about $23,000 in overtime for the infection preventionist on-call staff member and $25,000 in overtime for contact tracing.
“My business case was sharing all the data, and the goal was to prevent infections and improve safety for our patients in procedural and ambulatory settings,” Ormsby says. “If I didn’t have the resources to be present in those locations to do observations and do quality improvement initiatives, I could not reduce infections.”
Before presenting the business case, Ormsby had eight infection preventionists. After presenting the business case, she was able to hire four new infection preventionists and a manager of infection prevention.
“Historically, the focus has been on inpatient settings as opposed to procedural and ambulatory settings,” Ormsby said. “This is a challenge because more care is moving to the ambulatory setting such as day surgery. We need infection prevention staff members in those settings as well.”
In addition to making a business case for more staff, there is a business case for limiting infections in healthcare settings, according to Ormsby.
“The business benefits of reducing infections for the organization include not getting reimbursement if an infection is identified as a hospital-acquired infection,” Ormsby says. “Payers also can refuse to reimburse hospitals for surgical site infections.”
Christopher Cheney is the CMO editor at HealthLeaders.