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BEST PRACTICES
October 01

How to enroll senior leaders in an infection prevention strategy: 5 tips to success

Find the right language, metrics and champions to influence key stakeholders.

Infection Preventionist Meeting with Leaders

In healthcare, infection can spread through any one of three zones: the environment of care, through human-to-human contact or through clinical practice. To fight infection across all three zones, infection preventionists need resources and support from different teams.

To successfully drive change, infection preventionists have to be able to negotiate with and influence key decision-makers.1 Chief among them are senior leaders, such as heads of nursing, quality management and finance.

Hospital leaders play an important role in implementing infection prevention practices, and should be engaged at the onset of any program.2, 3 However, convincing leaders to invest more money, time and/or resources in an infection prevention program can be challenging due to a range of complex factors, such as pressures to cut costs and balance needs with the ongoing threat of COVID-19.

How can infection preventionists push past such barriers to engage senior leaders? Here are 5 helpful tips:

IP economic drivers

1 | Understand the economic drivers and their impact

Understanding the external forces that impact an organization’s overall performance can help infection preventionists understand the priorities of senior leaders and engage with them more successfully.4

“People like the CNOs or CFOs, they’re going to care about how infection control impacts metrics such as hospital rankings, how much they’re getting reimbursed and where they’re getting penalized. Meanwhile those who work more closely at the bedside might be more concerned with the patients under their immediate care and the processes they’re using to control infection day-to-day,” Lisa Petrilli, Head of The Medline Institute, says.

The external web of stakeholders who influences infection control programs4

IP web of stakeholders

The Centers for Medicare and Medicaid Services (CMS) is one of the key forces within the external landscape, Petrilli points out. The value-based programs they manage can reward or penalize hospitals based on their rates of infection. One example is the Hospital-Acquired Condition (HAC) Reduction Program, which penalizes the worst performing hospitals based on their cases of avoidable healthcare complications, including healthcare-acquired infections (HAIs) like MRSA and C. difficile.

1,865

hospitals have been penalized since the start of the HAC Reduction program

“Through value-based purchasing programs, hospitals are rewarded based on the quality of care they provide and penalized for HAIs. They also don’t get reimbursed when caring for someone with an HAI. Senior leaders are all acutely aware of these things, and if you want to enroll them, you should be as well,” Petrilli says.

IP business case

2 | Build a compelling business case

Along with understanding the economic landscape, making a compelling business case is essential to creating a successful IP program, especially in the age of dwindling resources and funding.5, 6

When building a case, the Centers for Disease Control and Prevention (CDC) recommends including a financial analysis that demonstrates a return-on-investment that’s tied to reduced patient harm.6 The oncology unit at one hospital did this, and won the support of their executive leadership. Then, upon implementing their intervention, they saw a 65% reduction in CLABSI rates.

“The key is to align the vision you have as an infection preventionist to the needs and priorities of your target audience,” Petrilli says. “When it comes to senior leaders, that means talking about the return-on-investment, for example how your approach can help them reach value-based purchasing goals such as lower infection rates, fewer readmissions or greater patient satisfaction.”

Lisa Petrilli

“They key is to align the vision you have as an infection preventionist to the needs and priorities of your target audience.”

Lisa Petrilli, Head of The Medline Institute

Observer Consistency icon

3 | Find an executive partner and a team of champions to help make your case

The CDC also recommends identifying executive partners who can advocate for infection prevention goals and share progress with other senior leaders and the hospital board.7 An ideal partner is someone who:

  • Has strong communication skill
  • Is approachable and willing to commit time
  • Is committed to patient safety
  • Is respected by their peers

Along with a senior-level advocate, Angela Zuick, Medline Director of Clinical Services, recommends finding champions among peer groups. Champions most likely to succeed are those who are already intrinsically motivated and enthusiastic about the practices they promote.8

“Especially if you’re an infection preventionist who’s just coming out of bedside nursing, you need experts in other areas of the hospital to help you understand how to move the needle,” Zuick says.

The need for team support is especially critical given that infection can spread across multiple zones of a healthcare setting. This makes the job of executing infection prevention programs not just the responsibility of the infection preventionist but the responsibility of multiple teams.

“You’re going to need the support of other teams to execute your vision, so it makes sense to find champions early on and leverage them as best you can,” she says. “For example, having an infectious disease physician join you in conversations with your CNO can help to show that there is cross-functional support for your ideas, which can help you build a stronger case.”

Angela Zuick, Medline Director of Clinical Services

“Especially if you’re an infection preventionist who’s just coming out of bedside nursing, you need experts in other areas of the hospital to help you understand how to move the needle.”

Angela Zuick, Medline Director of Clinical Services

vision and action plan

4 | Create a focused action plan

Another way to engage leaders is by showing them you have a good action plan.8 Plans should include a clear vision and goal, a timeline and risk analysis, according to the CDC. The organization also advises focusing first on the unit where you are most likely to succeed, then later expanding to other areas after demonstrating success.7

Choosing to focus on a specific need or area of opportunity, instead of the large-scale approach, can help make information easier for others to digest and potentially improve odds of success, Zuick argues.

“If you know your leader has a lot on their plate, has limited time or can get overwhelmed easily, consider narrowing your scope,” she says. “You can start that process by identifying the top one or two risks to your patient population when it comes to infection, whether that’s CAUTIs or CLABSIs, and using that as a lens to focus your efforts.”

be sensitive to IP challenges

5 | Be sensitive to the challenges teams face

While working to gain influence, infection preventionists should at all times “remain sensitive to the organization’s culture and ‘emotional intelligence’, as well as to the many competing priorities that can impact desired clinical and operational outcomes.”1 According to Petrilli, showing sensitivity is especially important today given the new and unique challenges created by the pandemic, from PPE shortages to rising expenses.

“All the changes happening have created an environment where it’s hard for anyone to come in and pitch something new. That’s why it’s so important for infection preventionists, when communicating their plan, to emphasize how it can help teams operate more efficiently or practice infection prevention more easily.”

Key takeaway

Infection preventionists are challenged to work and build consensus across multiple teams. When it comes time to engage senior leadership, there are actions infection preventionists can take to more effectively persuade and influence them. The first step is to gain a better understanding of the economic landscape surrounding healthcare. Next is to build a strong business case by showing ROI. While building their case, infection preventionists should create an action plan with a clearly defined scope and goal. Throughout the process, infection preventionists should find peers and executives to partner with as champions and keep team challenges and limitations top of mind.

Read more about infection prevention strategies:

Learn how you can target zero harm with a 3-zone strategy.

Get insights on how to build a culture of safety within your organization.

Discover how applying human factors can improve your CLABSI prevention plan.

References:

  1. Murphy, D.M. et al. Competency in infection prevention: a conceptual approach to guide current and future practice. American Journal for Infection Control: https://cdn.ymaws.com/www.osap.org/resource/resmgr/Grant_Projects/AJIC_article_Competency_in_i.pdf
  2. Centers for Disease Control and Prevention. Strategies for preventing healthcare associated infections. Available at: https://www.cdc.gov/infectioncontrol/pdf/strive/SP101-508.pdf. Accessed August 29, 2021.
  3. McAlearney, A.S. et al. Management practices for leaders to promote infection prevention: lessons from a qualitative study. American Journal of Infection Control: https://www.sciencedirect.com/science/article/abs/pii/S0196655320308580
  4. Weinstein, R.A. Who Is steering the ship? External influences on infection control programs. Clinical Infectious Diseases: https://academic.oup.com/cid/article/46/11/1746/376174
  5. Dhar, S. et al. Strategies for effective infection prevention programs: structures, processes, and funding. Infectious Diseases Clinics of North America: https://pubmed.ncbi.nlm.nih.gov/34362533/
  6. Pyrek, K.M. Making the business case for infection prevention. Infection Control Today: https://www.infectioncontroltoday.com/view/making-business-case-infection-prevention.
  7. Centers for Disease Control and Prevention. Creating a business case for infection prevention. Available at: https://www.cdc.gov/infectioncontrol/pdf/strive/BC101-508.pdf. Accessed August 29, 2021.
  8. Saint, S. and Greene, M.T. Preventing CAUTI: engaging clinicians and senior leadership to implement change. Agency for Healthcare Research and Quality: https://www.ahrq.gov/hai/cauti-tools/archived-webinars/preventing-cauti-engaging-leadership-slides.html
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