Leadership and policy implications

Increasingly, healthcare leaders are focusing their attention on preventing healthcare-associated infection. Indeed, recent empiric work demonstrates that certain characteristics of leaders (the term “leader” was applied broadly) were used by those perceived as being effective in implementing evidence-based infection prevention recommendations. Specifically, successful leaders tended to insist on a culture of clinical excellence which they instill through effective communication, thinking strategically while acting locally, inspiring staff, and taking a solutions-oriented approach to overcoming barriers. Importantly, some of the most important leaders in infection prevention activities are not senior executives. Examples abound of infection prevention personnel – hospital epidemiologists and infection preventionists – who play crucial leadership roles in their hospital’s patient safety activities. 

One important way to engage healthcare leaders – especially those in senior positions – in the topic of healthcare-associated infection prevention is through familiarity with the policy changes recently initiated by the Center for Medicare and Medicaid Services (CMS) that affect hospital reimbursement if adverse events occur during hospitalization. In brief, since October 2008, hospitals are no longer eligible for additional payment from CMS to treat several common and/or high morbidity hospital-acquired complications, such as catheter-associated urinary tract infections and pressure ulcers.  This same policy has also facilitated and encouraged public reporting of hospital-acquired condition events – another topic of high interest to healthcare leaders.   Therefore, this single policy regarding non-payment of hospital-acquired conditions may engage the interest of healthcare leaders along the lines of financial implications, patient safety, and public reporting.