AdventHealth Hospital Makes Impact by Doubling Infection Prevention Staff

The hospital has not had a central line-associated bloodstream infection or a catheter-associated urinary tract infection in the past eight months.

AdventHealth Celebration hospital has made gains by doubling its infection prevention and control (IPC) staff.

Infections including healthcare-associated infections are a major concern at hospitals. Healthcare-associated infections include central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs).

The Centers for Medicare and Medicaid Services (CMS) penalize hospitals that report high rates of healthcare-associated infections through the Hospital-Acquired Condition Reduction Program. In 2021, CMS penalized nearly 800 hospitals for healthcare-associated infections, with about $254 million in lost revenue.

AdventHealth Celebration has increased the hospital's IPC staff from 2.0 to 4.8 full-time equivalents. There have been several benefits from increasing the IPC staff, says Alric Simmonds, MD, vice president and CMO of AdventHealth Celebration and chief health equity officer for AdventHealth.

"First, increasing the IPC staff allowed them to have more of a proactive presence in the operating rooms, on the inpatient floors, and the ICUs," he says. "Second, it allowed them to be able to integrate more with our physicians. Third, it allowed them to have a more proactive understanding and thorough analysis of infection prevention challenges as well as the opportunity to conduct more education about the importance of infection prevention."

Since AdventHealth Celebration's IPC staff was doubled, all hospital-acquired infections have been low compared to national benchmarks, Simmonds says. "We have gone eight months without a CAUTI or CLABSI," he says.

A powerful business case can be made for having robust IPC staffing, Simmonds says.

"Under our guardianship, patients have the expectation that they will have an excellent outcome without complications such as infections," he says. "From a revenue standpoint, there are penalties from CMS for infections. There can also be erosion of the CMS five-star rating for hospitals, which affects our marketing. In addition, hospital-acquired infections can impact our Leapfrog patient safety score."

There also is a "material impact" from hospital-acquired infections, Simmonds says. "If you have an infection, you need to provide additional care such as antibiotics and wound care. So, having an effective IPC staff decreases the cost of care," he says.

One of the initiatives that has been launched by AdventHealth Celebration's enlarged IPC staff is a CAUTI Bootcamp.

"We train staff on how a CAUTI arises," Simmonds says. "The bootcamp addresses how we can remove catheters in a timely manner. The training includes sterile technique, the proper cleansing of the perineum, proper glove utilization, and proper insertion and maintenance of catheters."

Guiding the hospital's clinical staff on appropriately reducing catheterization of patients is a crucial element of the CAUTI Bootcamp, Simmonds says. "We need to seize on opportunities to not have an indwelling catheter for a patient," he says.

The bolstered IPC staff at AdventHealth Celebration is having a far-reaching impact on the hospital, Simmonds says.

"They can be ever-present," he says. "They are part of our leadership team. They are a member of our Patient Safety and Quality Committee. They are driving metrics. They help shape the culture of safety and high reliability from a hygiene and infection-prevention standpoint. They are a clinical arm that is tactically deployed to address infection concerns, and they get in front of infection concerns so that patient harm is prevented. They are additive to the clinical outcomes that we achieve at our hospital."