Faced with shrinking bottomlines, many hospitals have recently been paring back their infection prevention programs. However, these short-term solutions may be costing them more in terms of costly hospitalizations related to infections, according to a survey by the Association for Professionals in Infection Control and Epidemiology released this week during its annual conference.
Of the nearly 2,000 APIC members responding to a survey in late March, 41% reported cuts in their budgets related to the economic downturn in the past 18 months. These cutbacks have come in the form of reduced staffing (39%); hiring freezes (35%), reduced education funding (74%), and reduced infection prevention budget (53%).
"Cuts have made it harder to do the work that protects patients," said APIC President Christy Nutty, who is an infection control consultant in Metropolis, IL. In particular, about 44% attend fewer meetings at their hospitals; 45% said they received less support for attending educational meetings; 42% have fewer walking rounds; and 38% have cut educational activities for families, staff, and patients.
One of the problems is that in recent years, the amount of work for infection prevention has increased, Nutty said. While staffing and related resources have decreased, new reporting requirements have risen—which can take time away from the infection prevention work.
While transparency—in the form of public reporting—could lead to better outcomes, fewer institutions have received additional resources to compensate for these added regulations, Nutty said. "This leaves infection prevention struggling to do much more with much less."
Deaths are still occurring from infections: for instance, about 30,000 hospital deaths annually are from blood stream infections; 36,000 cases are related to ventilator-associated pneumonia, Nutty stated.
For surgical site infections, costs can run as high as $25,000 in excess of what it would cost; bloodstream infections, $36,400 more; VAP, about $10,000 more; and urinary track infections, $1,000.
"Remember, these are excess costs"—above and beyond what is now paid with Medicare money, said Denise Murphy, vice president for quality, Main Line Health System, and a former AHIC proposal.
Eliminating extra days in hospitals by preventing infections can save those hospitals money—especially when Medicare is declining now to pay for those hospital-acquired infection cases requiring longer hospitalizations, Murphy said.
For instance, preventing just 10 surgical site infections would open up about 260 bed days—plus increase income, Murphy said. If 10 bloodstream infections are eliminated, that would pay for an "effective program" that includes two executive infection preventionists, clerical support, and half a medical director, Murphy added.