2004 Salary Survey Results: No shortage of mandates, but ICP salaries, raises plateau

2004 Salary Survey Results

No shortage of mandates, but ICP salaries, raises plateau

To see tables illustrating the 2004 Salary Survey results, click here.

Silver lining: Plenty of jobs for experienced ICPs

Infection control professionals had a median salary in the $50,000 to $59,000 range, but many are struggling to get department resources despite an onslaught of regulatory and accreditation requirements, according to the 2004 salary survey by Hospital Infection Control.

The HIC survey of 325 ICPs found median salaries staying in the same range they have been for several years and median raises again in the 1% to 3% range. In percentage breakdowns of the respondents, 18% were making $40,000 to $49,000; 26% were paid $50,000 to $59,000; and 23% had salaries in the $60,000 to $69,000 range. On opposite ends of the spectrum, 6% were making $30,000 to $39,000; and 14% were in the $70,000 to $79,000 range.

While some respondents were relatively new to infection control, few were new to health care. Overall, the median number of years in infection control was 10 to 12, but the median time spent in health care was 22 to 24 years. Such experience spells wage growth over time, but raises in the short term were unremarkable. Indeed, 18% of respondents did not receive a raise. Overall, 20% drew raises of 4% to 6%, and 6% of respondents were given a raise in the 7% to 10% range.

Bottom line: Infection control has gotten an unprecedented level of attention over the last few years, but it has yet to translate to substantive changes in the historically marginal levels of support for the field.

"Health care [administration] is aware of the patient safety movement, but I don’t think the administrative folks, in general, are aware of the emphasis put on infection control by all the accrediting bodies and regulatory agencies," says Deanie Lancaster, RN, BSN, MS, CIC, infection control director at St. Thomas Health Systems in Nashville, TN.

"They sort of superficially understand it, but they don’t understand the mandates connected with it and how much time and resources it does take," she points out.

Indeed, on the heels of the national patient safety movement, there are now new respirator fit-testing requirements by the Occupational Safety and Health Administration. In addition, individual states are starting to pass infection rate disclosure laws that put pressure on infection control departments to meet yet another mandate. As in other states, Tennessee now is requiring ICPs to collect and report data on certain infections. "We are required to report any sentinel or serious events to the state department of health, and infections are one of the those," Lancaster says.

For it’s part, the Joint Commission on Accreditation of Healthcare Organizations has issued new infection control standards for 2005. Unveiled with much fanfare, the standards call for infection control to be a major component of hospital safety that enjoys the support and collaboration of "leaders across the organization." When the new standards were released last year, Dennis O’Leary, MD, president of the Joint Commission went so far as to warn, "they put leaders of health care organizations on notice and on point. If things go south for any reason, . . . [there is] no opportunity or permission to defuse the responsibility."

Has that call for action translated to increased resources for these ever-more-important infection control programs? "That is the critical question, and I think the jury is out," says William Scheckler, MD, a veteran epidemiologist who was on the Joint Commission’s special advisory panel when it was forming the standards. "The standards that they put in effect are for 2005, so the key thing will be to see how well people are meeting this notion that the CEOs — the upper-level administration — are making sure that there are adequate resources for infection control."

While it’s too early to make a clear call, we posed the same question to an ICP who has worked both as an independent consultant and within the hospital walls. "From my perspective, no — but I’m in a small community hospital in Montana, "says Bonnie Bernard RN, MPH, CIC, an ICP at St. Peters Hospital in Helena. "Joint Commission has never really done a good job in terms of supporting resource planning. Even in the survey process, they will say that, It doesn’t appear that you have enough resources,’ but they never put that as a recommendation [for action]. That’s happened at my facility twice. If it’s not in a recommendation, it doesn’t happen."

Consultant or hospital-based?

Concerning her foray into consulting, Bernard says it can be as rewarding a job as a hospital practice but it presents different demands. "The reason I came back [to a hospital] is that I didn’t want to do all the marketing," she says. "You have to do the work, and you have to market yourself. That was my choice, but I still think that is a very viable option."

Indeed, ICP consultants fill a critical gap for small hospitals that can’t afford a full-time professional. "Smaller hospitals are not going to find somebody at a 0.5 [FTE] that has the expertise they need to do a good infection control program," she says.

Like Barnard, most survey respondents work in small hospitals. While the median bed size of all respondents’ facilities was 201 to 300 beds, 25% had 200 beds or less, and 23% had less than 100.

That finding might go a long way toward putting everything else in the survey in perspective.

"Frankly, there just aren’t resources," Bernard says. "Some of these little hospitals are even operating in the red most of the time."

But progress is being made on some fronts. Lancaster says the ICPs in her hospital system were able to get pay raises after doing a little homework and a lot of lobbying.

"We did a market survey here in the Nashville area, and our ICPs here at St. Thomas got a raise," she says. " I think health care has sort of plateaued off on a whole lot of financial issues, particularly salaries. With ICPs, the issue is that most of the positions are salaried rather than hourly. Our two ICPs had not had a real market adjustment since 1999. St. Thomas is a five hospital system and the other ICPs in the other facilities also got a raise because we pushed it here."

While raises may take a little arm twisting, actually landing a job appears to be good possibility for an experienced ICP. "You didn’t see this years ago, but most of the [new jobs], they want people who are certified," Lancaster says. "They don’t want to have to train them, they want them to come in certified."

Indeed, employers are getting so used to the jack-of-all trades aspect of ICP work that one web-based job site said it had plenty of work for those fitting this description:

"You are an expert in everything to do with infectious conditions: risk factors, epidemiology, aseptic technique, and hospital and governmental hygiene regulations. You have the much-admired ability to collect and analyze complex statistics and translate these into comprehensive reports. You are highly organized and detail-oriented and are able to lead staff to successfully implement infection control practices."

And we might add, you are the key to making sure your facility meets all manner of state and federal regulations and accreditation demands in a time of unprecedented national focus on infection control. "We’ve gotten a lot of attention, and I think that’s good," Barnard says. "But the next step is the resources to actually get stuff done."

Administrators, are you listening?

(Editor’s note: The ICP job openings can be viewed at www.medhunters.com/jobs/Inf_Control.html.)