the business case for infection prevention and control: educating yourself and your exe c utives
DESCRIPTION
The Business Case for Infection Prevention and Control: Educating Yourself and Your Exe c utives. Denise Murphy, RN, BSN, MPH, CIC Vice President, Quality and Patient Safety Main Line Health System Philadelphia, PA. Cost. Benefit. VS. About the Business Case (Objectives). - PowerPoint PPT PresentationTRANSCRIPT
The Business Case for The Business Case for Infection Prevention and Infection Prevention and
Control: Control: Educating Yourself and Your Educating Yourself and Your
ExeExeccutivesutivesDenise Murphy, RN, BSN, MPH, CICVice President, Quality and Patient
Safety Main Line Health System
Philadelphia, PA
• What is the business case…from everyone’s perspective and how to share it with decision-making leaders – Clinical impact: morbidity and mortality– Cost of infections… the total cost
• How to get the investment if it isn’t already there– Use of hard data, influence and persuasion– In negotiations…timing is almost everything!
• How to use the investment and demonstrate returns so you can keep it
VS.Cost Benefit
About the Business About the Business Case (Objectives)Case (Objectives)
TOTAL = 1.7 million HAI• 1.3 million adults & children
outside of ICU• 418,000 adults and children in ICU• 33K newborns in high-risk nurseries• 19K newborns in well-baby nurseries• 9.3 HAI/1,000 pt. days• 4.5HAI/100 admissions Excess LOS: 7.5 million daysExcess charges: >$6.5 billion
*Nicolas Graves. Economics of Preventing HAIs; **Klevens, Edwards, Richards et al.*Nicolas Graves. Economics of Preventing HAIs; **Klevens, Edwards, Richards et al. Pub Health Report. Pub Health Report. 2007 2007
The U.S. Burden of The U.S. Burden of HAIHAI
Death from HAI (U.S. Death from HAI (U.S. 2002)2002)
0
N = 98,987
36K
31K
13K
8K11K
Num
ber
Dea
ths
in
Tho
usan
ds
5
10
15
20
25
30
35
40
Pneumonia
BSI
UTI
SSI
Other HAI
Source: Public Health Report/March-April 2007/Volume 122
The Most Important Bottom Line!
Attributable CostsAttributable Costs
Type HAI Attributable Costs
Mean (SD)
Range
Surgical Site $25,546 (39,875) $1783 – 134,602
Bloodstream $36,441 (37,078) $1822 – 107,156
Vent. Associated Pneumonia
$9669 (2920) $7904 – 12,034
Urinary Tract (UTI) $1006 (503) $650 - 1361
70 studies: 39 US, 17 Europe, 4 Australia/New Zealand, 10 other. Analysis includes only those studies that calculated individual (vs. aggregate) cost of patient outcomes.
SOURCE: Stone et al. AJIC Nov 2005; 33:501-509
HAI Cost Analysis January 2001 – June 2004
SOURCE: Eli N. Perencevich, MD, MS; Patricia W. Stone, PhD, MPH, RN; SOURCE: Eli N. Perencevich, MD, MS; Patricia W. Stone, PhD, MPH, RN; Sharon B. Wright, MD, MPH et al. Sharon B. Wright, MD, MPH et al. Infect Control Hosp EpidemiolInfect Control Hosp Epidemiol 2007;28:1121-1133 2007;28:1121-1133
Author: R. Douglas Scott II, Economist, CDC, DHQP March 2009Author: R. Douglas Scott II, Economist, CDC, DHQP March 2009
Economic ComparisonEconomic Comparison
N = 20 Patient
Admit diagnosis Respiratory failure Respiratory failure
Age 71 75
Payer Medicare + commercial Medicare + commercial
Revenue $ 20,792 20,417
Expense $ 19,501 37,075
Gross margin $ +1,291 -16,658
Costs attributable to BSI 13,696
LOS (days) 10 15
Source: Shannon et al. Source: Shannon et al. Amer J Med QualityAmer J Med Quality Nov/Dec 2006; pgs 7S-16S Nov/Dec 2006; pgs 7S-16S
Without CLABSI With CLABSI
Volumes and Patient Flow Volumes and Patient Flow = $$$= $$$
• Patients without HAI are discharged sooner• New patients move into those beds• Assuming fixed costs stay the same (building,
utilities, etc.), available “bed-days” increase volumes and revenue, reimbursement.
• Example: Table 1. shows CABG SSI mean excess LOS = 26 days. *Preventing 10 CABG SSI would open up 260 “bed-days”. If average LOS without complication is 4 days, then 65 new patients could be admitted.
*Modified from: Perencevich, Stone, Wright*Modified from: Perencevich, Stone, Wright
Estimation Estimation MethodsMethods
• Compare costs for patients with infections to patients without infections (matched comparison; like case-control study)
• Problem: are the patients who get infection just like those who do not?
AgeGenderDiabetesSmokingWeight
C.S. Hollenbeak, 2006
Where Can You Start?Where Can You Start?– Select type of infection to estimate; SSI easiest– Use accounting dept to obtain individual costs and
LOS for patients undergoing specific surgical procedure
– List patients who developed SSI. – Use accounting to calculate additional costs:
readmission, return to OR, ICU stay, antibiotics, etc.– Compare cost of patients without SSI to patients
with SSI who had procedure during same time period
– Compare length of hospital stay, including readmission for SSI, for those with infection
Societal Costs of HAISocietal Costs of HAI
Direct cost savings: – No routine ventilator circuit changes– $1M savings across BJC
(equipment/supplies)
Indirect cost savings– Increase in Respiratory Therapist
productivity due to fewer vent circuit changes (focus on reducing VAP)
– 25% increase in flu vaccine (lower RN absenteeism/ agency costs)
Applying Economics….Applying Economics….to IPC Practiceto IPC Practice
Cost (or revenue loss) avoidanceOutbreak of SSI: difference in observed vs. expected SSI rates/excess cost & LOS ($37K & 18 d.)*– Reduced excess cost and LOS (reimbursement
lower after 3-5 days of re-admission for SSI)– Reduce adverse outcomes on CMS list of
“healthcare acquired conditions” that will no longer receive associated excess reimbursement (e.g., CR-BSI; Mediastinitis, Total Joint Replacement; Bariatric SSI; UTI)
Comparison of Endemic vs. Epidemic SSI Rates
BJC Operating unit: Hospital APeriod of increased SSI 6/98 - 12/98Surgical procedure Gastric BypassNumber of procedures performed in 1998 70Reported “benchmark” SSI rate/100 procedures 2.7-5.1Operating unit endemic rate/100 procedures 2.86% (2 SSI / 70 procedures)Operating unit epidemic rate/100 procedures 22.6% (7 SSI / 31 procedures)Average LOS for uninfected vs. infected 4 days vs. 22 daysMean excess LOS per SSI 18 daysAverage cost for uninfected vs. infected $7,816 vs. $44,963Mean excess cost per SSI $37,147Rate reduced to baseline/ benchmark (date) 3.0% (4/99 through 4/2000)Projected # procedures 2000 70 casesExpected # SSI based on endemic (3.0) rate 2 SSIExpected # SSI based on epidemic (22.6%) rate 16 SSI
# SSI avoided (based on *reduced rate) 14 SSI annually
*Estimated cost avoidance 1999 - 2000 $520,058 ($37,147 x 14)*Estimated cost avoidance is based on the #SSI avoided annually when rates remain at baseline (endemic) compared to epidemic rates.
SAMPLE REPORT
Lost opportunity costs– Fewer CABG SSI resulted in fewer I&D cases in
OR; – Opportunity for more 1st time CABG surgery cases
brought higher reimbursement
Intangible costs– Lessen risk for negative PR (impact on referrals)– Impact on societal trust– Changes in insurance premiums due to high HAI
costs– Impact on status with accreditation and regulatory
agencies
Attributable Cost– Much better estimate of cost attributable to
infection– Use economic modeling to tease out in-pt. cost of
other co-morbidities* diabetes costs include glucose monitoring, insulin CHF costs include Rx with ACE/ARB/beta blocker
– Much easier to do with surgical patients: readmission/ re-operation purely due acquisition of SSI
– Found attributable cost of CABG SSI ~$20K in our study; ($35K deep chest; 15K non-deep SSIs)*
*Source: Hollenbeak CS, Murphy DM, Dunagan WC, Fraser VJ. Chest 2000; 118:397-402.
Personal/Individual Personal/Individual CostsCosts
• Physical pain and discomfort• Mental and financial stress• Increased length of stay in hospital• Prolonged or permanent disability• Disruption to patient and family• Time lost from work for patient
and caregivers • Death
Communicating Communicating Financial ImpactFinancial Impact
– Display cost and LOS data graphically– Approach Clinical Leadership and Senior
Executives to demonstrate financial impact of HAI (avoidable cost, opportunity cost, revenue enhancement)
– Use *literature to show cost-benefit of Infection Prevention – impact of interventions to reduce HAI
– Demonstrate your value!– You then argue for a larger investment in IPC…
*Raising Standards While Watching the Bottom Line: Making a Business Case For Infection Control .
Eli N. Perencevich, MD, MS; Patricia W. Stone, PhD, MPH, RN; Sharon B. Wright, MD, MPH;
Yehuda Carmeli, MD, MPH; David Fishman, MD, MPH; Sarah Cosgrove, MD, MS.
Infect Control Hosp Epidemiol 2007; 28:1121-1133
Getting local information is Getting local information is
powerful powerful but complicated.but complicated.
Pick something, be able to Pick something, be able to explain it, explain it,
then stick to it!then stick to it!
Consider Using the Consider Using the Literature Literature
and Adjusting Dollarsand Adjusting Dollars Healthcare inflation rate has been about 4 -4.5%
annually, so 1985$ ~ adjusting up to 2009$ means multiplying EACH YEAR between 1985-2009 by annual inflation rate.
This is a very crude adjustment. Medical care services increased 5.2% in 2007,
2.6% in 2008 and 3.4% in 2009 A BSI that cost $38,336 in 2007 (36,441 x 1.052
or 5.2%) will cost $39,337. in 2008 (38,336 x 1.026 or 2.6%) and $40,674 in 2009 (39,337 x 1.034 or 3.4%)
Or use the CPI “cost calculator! http://www.bls.gov/data/inflation_calculator.htmhttp://www.bls.gov/data/inflation_calculator.htm
Source: D. Murphy, 2006 revised 2011
How about a 5% inflation rate for the sake How about a 5% inflation rate for the sake of adjusting costs in literature?of adjusting costs in literature?
After You’ve Made the After You’ve Made the Business Case…Business Case…
Learned organizational priorities – aligned with them Created the IPC mission, vision, goals and objectives Obtained resources to support effective program Tracking on goals, reducing HAI rates...what next?
“The more you know about executive leadership, the more executive leadership knows about you.”
Wharton School of Business; University of PA
Demonstrate Functional ValueDemonstrate Functional Value
• Eliminating waste/improving productivity through
Wise product selectionAppropriate application of expensive technologySensible policies & proceduresProtection of employees from injury
• Maintaining regulatory compliance• Creating effective collaboration between clinicians and administration• Creating a safer environment for patients and staff, increasing satisfaction; maintain reputation for service
Demonstrate Strategic ValueDemonstrate Strategic Value
Supporting organization’s strategic plan
To grow volumes:To grow volumes: Empty out ICU beds more quickly by reducing
To grow services:To grow services:Show how interventions to reduce HAI rates on specific services can be utilized to plan and design new programs and servicesGastric bypass surgery new for your organization? Use literature and experience of others to build in risk reduction strategies.
To hit target on 100% of quality To hit target on 100% of quality scorecards!scorecards!
Same skills used for outbreak investigation can help PI teams get to root causes of poor performance.
Planning - Planning - StrategiesStrategies
Lay out three year plan with someone who knows how Tactics to meet goals – refine them each year
Focus on the critical few firstFocus on the critical few first Needs assessment –
do one every year; even a *SWOT Analysisuse to create long and short term goalssetting direction based on assessment new goals and priorities
*S*Strengths, WWeaknesses, OOpportunities, TThreats
Planning - Planning - StrategiesStrategies
Evidence-based medicine: as it changes, your interventions must follow: Need system for keeping up, environmental scans, literature search, journal clubs.
Performance Measurement and Improvement basics
Tools, methods, SMART goals and meaningful metrics - with accurate data analysis and reportingTrained facilitators and leadersExecutive and physician championsOutbriefs to educate, engage and gain leadership commitment
Budget / Financial ManagementBudget / Financial Management
Budgeting – take and keep some control Resources vs. what program can/cannot do…just say NO! Role of technology: cost / benefit analysis, use literature, experience of others Executive incentives / Scorecard and dashboards:
exert influence on senior leadership to include HAIs
Board education about HAIs and impact of interventions will help sustain financial support from management
The Business PlanThe Business Plan
Not One and Done, continue demonstrating value and:
Use data to show current state; Highlight successes and ROI Outline short and long term needs Propose IPC expansion aligned with resources Request professional development opportunities Propose technology solutions that have been proven Access to clinical/administrative decision-makers
Action Plans and Action Plans and TacticsTactics
to Drive the Actionto Drive the Action Specific actions to fix broken processes and systems Specific actions to address staff behavior/compliance Responsible parties to drive each tactic or step Timelines Required resources to complete actions Briefings to senior leaders Make performance transparent: briefings/scorecards Watch for barriers in each step of implementation
If Everyone is If Everyone is Responsible…Responsible…
Action Item Who is Responsible
By When
Post screen saver C. Hampton 4/24/08
Communication plan(Publications, Meetings)
J. Gagliardi Upon completion of final
RIE
Place line removal training module on Pathlore (intranet)
V. FerrisA. Dixon
05/16/08
Central line removal pictures
M. SchultzV. Ferris
4/24/08
Sustaining the Sustaining the GainsGains
Accountability through monitoringResponsible parties reporting to key leadersClear expectations and follow upWhat’s in it for those who must change/sustainPerformance management – discuss how to keep people compliant: part of their performance expectations…they are evaluated on patient safety and IPC!
HUMAN FACTORS and impact on compliance!
Demonstrating The Value of Demonstrating The Value of Infection Prevention and Infection Prevention and
ControlControl
Know the Cost of Know the Cost of EffectiveEffective Infection Prevention and Infection Prevention and
ControlControlAnnual Cost(s)
Personnel 0.5 Physician 70,000 1 Nurse 30,000 1 Secretary 15,000
0.5 Computer Programmer 15,000Supplies, fax. Etc. 20,000Fringe benefits and overhead 50,000
Total $200,000*
Wentzel. J Hosp Inf 1995; 31: 79-87; *1992$
*Add computer & adjust for inflation, this cost would be >$315,000 in 2011
:(
Remember, this is 1992 $$
Plan for the Resources You Need!Plan for the Resources You Need!Sample IPC Program BudgetSample IPC Program Budget
Staff = 2 IPs; 1 Secretary; 1 Medical Director
Acct. Desc. Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total
Salaries (Professional) 7,084 7,084 7,084 7,084 7,084 7,084 7,084 7,084 7,084 7,084 7,084 7,084 125,008
Salary (Clerical) 2,083 2,083 2,083 2,083 2,083 2,083 2,083 2,083 2,083 2,083 2,083 2,083 24,996
Misc. Benefits 2,291 2,291 2,291 2,291 2,291 2,291 2,291 2,291 2,291 2,291 2,291 2,291 37,492
Minor Equip. 1,000 1,000
PCs 5,000 5,000
Software 1,000 1,000
Office Supp. 100 100 100 100 100 100 100 100 100 100 100 100 1,200
Publications 200 200 400
Telephone 72 72 72 72 72 72 72 72 72 72 72 72 864
Education 2,400 2,400 4,800
Postage 10 10 10 10 10 10 10 10 10 10 10 10 120
Travel 100 100 100 100 100 100 100 100 100 100 100 100 1,200
Special Events 584 2920 3504 7,008
Printing Purchased 25 25 25 25 25 25 25 25 25 25 25 25 300
Purchase MD Services 5,417 5,417 5,417 5,417 5,417 5,417 5,417 5,417 5,417 5,417 5,417 5,417 85,004
Lab 416 416 416 416 416 416 416 416 416 416 416 416 5000
2010 BUDGET TOTAL 300,392
Secure Resources to Secure Resources to
Support Effective Support Effective ProgramsProgramsIPC resources should be allocated based
on:– Demographics of population– Most common diagnosis– High risk populations– Services offered– Type and volume of procedures performed– What is NOT BEING DONE due to
inadequate resources THAT SHOULD BE DONE to improve patient care
*O’Boyle C, Jackson MM, Henly SJ. Staffing requirements for infection control programs in US Health care facilities: Delphi project. AJIC 2002;30;6:321-33.
Staffing Staffing Requirements?Requirements?
O’Boyle C, Jackson MM, Henly SJ. Staffing requirements for infection control
programs in US Health care facilities: Delphi project. AJIC 2002;30;6:321-33.
2001 Delphi Study•*0.8 to 1.0 ICP per 100 occupied
beds acute and long-term care• Physician time not measured
How did we get more resources at my hospital?
Constant assessment and relentless annual negotiations.
Looking outside of hospital: contracts for IPC services, grants support temporary resources (students, data collection), Internship program support (MPH, MHA).
Proving our value year after year; increasing visibility of program; focusing on interventions = REDUCING HAIs!
FOCUS ON FOCUS ON INTERVENTIONS!INTERVENTIONS!
What Percent of HAIs What Percent of HAIs
are Preventable? are Preventable? • In 1985 SENIC study estimated 32% of HAIs
preventable if effective IC program in place*
• 1995: British Hospital Infection Working Group stated that about 30% of HAIs could be avoided by better application of existing knowledge**
• 10-70% HAIs preventable with appropriate infection control depending on setting, study design, baseline infection rates and type of infection***
• Concluded at least 20% of all healthcare-associated infections probably preventable***
Sources: Haley, et al. Study on the Efficacy of Nosocomial Infection Control
Am J Epidemiol 1985; 121:159-67, 182-205*
Management and Control of HAI in Acute NHS Trusts in England. Feb 2000**
Harbarth S, et al. J Hosp Infect 2003;54:258-266***
Getting to Zero Getting to Zero HAIHAI
• Targeting zero =culture change
• Strong Sr. Leader support/CHAMPIONS/ multidisciplinary teams
• Bundle approach/EBM• Transparency/data
feedback• Analysis – real time• Personalize HAI• Communication!• Celebrate• Market value of IP
• Critical event analysis• Daily assessment of
device use/reminders to remove
• Board involvement• IPC Liaisons • Weekly Executive
Report• Web-based education• Empowered staff STOP THE LINE• Human Factors training
What’s Standard?What’s Standard? What’s Different?What’s Different?
Development costs:6 IPs @ $23/2 hrs./12 mos. =$3,312Graphics & printing =$1,300 $4,612Implementation costs:20 ICPs @ $23/16hrs. = $12,000600 RNs @ $23/1hr. = $13,800100 PCTs @ $12/1hr. = $ 1,20052 MDs @ $100/1hr. = $ 5,200 $32,200Development & Implementation costs = Development & Implementation costs = $36,812$36,812
Cost Benefit Cost Benefit AnalysisAnalysis
IPC BSI
Example: Intervention Modules to Prevent CLABSI – 2 ICUs @ BJC
Cost Benefit Analysis Cost Benefit Analysis (continued)(continued)
CLABSIs prevented (in 2 ICUS) in 2000
Expected BSI = 90 (based on previous two years rates)Observed BSI = 45BSI prevented post intervention = 45Estimated cost savings = $4,500 x 45 = $202,500
Cost Savings - Intervention Costs = Net Savings $202,500 - $36,812 = $165,688
So what’s mySo what’s myreal return onreal return oninvestment?investment?
NOTE: Once our value was established, we didn’t have to keep proving it NOTE: Once our value was established, we didn’t have to keep proving it to executives (in dollars saved!) We changed the way they think about IPC! to executives (in dollars saved!) We changed the way they think about IPC!
We just have to keep reducing infections!We just have to keep reducing infections!
BJC HealthCare – BJC HealthCare – Impact of InterventionsImpact of Interventions to Decrease HAIs to Decrease HAIs
CABG Surgical Site Infections (SSI) 2000 2001 Impact of Interventions#SSI 116 86 -30%SSI 5.21% 4.26% -26%Excess Cost $2,440,000 $1,737,945 -$801,340Spinal Surgical Site Infections (SSI)#SSI 64 58 -6%SSI 1.7% 1.5% -10%Excess Cost $716,345 $659,394 -$90,000Bloodstream Infections (BSI)#BSI 564 542 -22BSI/1,000 patient days 3.5/1,000 3.4/1,000 -4%Excess Cost $2,639,520 $2,639,540 -$107,140
#VAP 294 160 -134VAP/1,000 ventilator days 7.5/1,000 3.9/1,000 -46%
Excess Cost $2,449,020 $1,385,600 -$1,160,440
Total Cost of All HAI tracked $8,244,885 $6,422,479 -$2,158,920
Ventilator Associated Pneumonia (VAP)
Barnes-Jewish HospitalBarnes-Jewish HospitalExcess Cost of HAIExcess Cost of HAI
2000 to 2007
$0
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
$7,000,000
$8,000,000
$9,000,000
2000 2001 2002 2003 2004 2005 2006 YTD 2007
Exc
ess
Co
st
Barnes-Jewish HospitalBarnes-Jewish HospitalExcess LOS Associated with HAIExcess LOS Associated with HAI
2000 to 2007
0
500
1000
1500
2000
2500
3000
3500
4000
2000 2001 2002 2003 2004 2005 2006 YTD 2007
Ex
ce
ss
Le
ng
th o
f S
tay
(D
ay
s)
Main Line Health System Cost of Infections July 2008 - December 2010
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
July-Sept08
Oct-Dec08
Jan-Mar09
Apr-June09
July-Sept09
Jan-Mar10
Apr-Jun10
Jul-Sep10
Oct-Dec10
Co
st o
f In
fect
ion
s
CA UTI
SSI
VAP
CLABSI
What impresses leaders the What impresses leaders the most?most?
Let’s look at the Let’s look at the Chief Financial OfficersChief Financial Officers
Presentation of Presentation of achievements at theachievements at the
MLH Annual Leadership MLH Annual Leadership MeetingMeeting
Main Line Health (Critical Care Main Line Health (Critical Care Units) Units)
CLABSI (#) April 2008 - March CLABSI (#) April 2008 - March 20112011
65
4
2
12
4 6
10
9
7
1
3
Apr-Jun2008
Jul-Sep Oct-Dec
Jan-Mar
2009
Apr-Jun Jul-Sep Oct-Dec
Jan-Mar
2010
Apr-Jun Jul-Sep Oct-Dec
Jan-Mar
2011
Data Source: NHSN via DMA Infection Control Database
83% decrease from second quarter of 2008 to first quarter 2011
Trend line: p< .005, R2 = 0.59
Main Line Health Main Line Health (*All (*All Patients)Patients)
CLABSI (#) April 2008 - March CLABSI (#) April 2008 - March 20112011
28
22
12
97
10
7
17
2623
18
10
Apr-Jun2008
Jul-Sep Oct-Dec
Jan-Mar
2009
Apr-Jun Jul-Sep Oct-Dec
Jan-Mar
2010
Apr-Jun Jul-Sep Oct-Dec
Jan-Mar
2011
*All Patients = all patients in house with central line
Data Source: NHSN via DMA Infection Control Database
75% decrease from second quarter of 2008 to first quarter 2011
Trend line: p< .001, R2 = 0.71
Main Line Health (Med/Surg/Tele Main Line Health (Med/Surg/Tele Units) Units)
CAUTI (#) April 2008 - March CAUTI (#) April 2008 - March 20112011
Data Source: NHSN via DMA Infection Control Database
22
26
16
11
7
1113
10
13
8
7
10
Apr-Jun'08
Jul-Sep Oct-Dec Jan-Mar'09
Apr-Jun Jul-Sep Oct-Dec Jan-Mar'10
Apr-Jun Jul-Sep Oct-Dec Jan-Mar'11
68% decrease from second quarter of 2008 to first quarter 2011
Trend line: not significant, R2 = 0.29
Main Line Health (Critical Care Main Line Health (Critical Care Units) Units)
Ventilator Associated Ventilator Associated Pneumonia (#)Pneumonia (#)
April 2008 through March April 2008 through March 20112011
18
30
4 3
63
6
3
15
2 5
5
Apr-Jun2008
Jul-Sep Oct-Dec
Jan-Mar
2009
Apr-Jun Jul-Sep Oct-Dec
Jan-Mar
2010
Apr-Jun Jul-Sep Oct-Dec
Jan-Mar
2011
67% decrease from second quarter of 2008 to first quarter 2011
Trend line: p< .05, R2 = 0.45
Data Source: NHSN via DMA Infection Control Database
A few other pearls…A few other pearls…
Your IPC CultureYour IPC Culture
Culture is the set of beliefs and values, learned organizational behaviors, the way we do things around here
Can you describe the culture of the IPC program?
Service culture? Safety culture? What do customers want from you and your program? How do you get others to embrace IPC culture
PartnershipsPartnerships
Champions, partners, facilitators – actively seek them out, work to keep them: WIIF them?
Patient Safety/Risk Management; Performance/Quality Improvement Data management and analysis Information Technology Occupational Health Accounting and finance
Financial impactIPC program and intervention investment ROI
Marketing – celebrate successes widely
Managing Your BossManaging Your BossMake sure you understand your boss and his or her context, including:Goals and objectivesPressuresStrengths, weaknesses, blind spotsPreferred work style
Assess yourself and your needs, including:Strengths and weaknessesPersonal stylePredisposition toward dependence on authority figures
Develop and maintain a relationship that:Fits both your needs and stylesIs characterized by mutual expectationsKeeps your boss informedIs based on dependability and honestySelectively uses your boss’s time and resources
Source: Harvard Business Review (checklist) May-Jun 1993
59
Thanks for your time and attention!Thanks for your time and [email protected]@mlhs.org