CDC, state health depts build bridge to HAI prevention

January 12th, 2015

State health departments are becoming promising partners with the Centers for Disease Control and Prevention in an increasing national effort to eradicate healthcare associated infections (HAIs). Many state health departments initially became engaged in HAI prevention as state infection reporting laws spread across the map. There is the potential for considerably more than data collection, however, as state health departments are uniquely positioned to help the CDC move surveillance and prevention measures beyond the hospital and into a wide variety of settings like dialysis centers and long-term care, “We are very focused on increasing the role of state health departments,” says Michael Bell, MD, associate director for infection control in the CDC′s Division of Healthcare Quality Promotion. “The reason for that is [for example] the world of dialysis organizations is completely detached from many of hospitals. Similarly, if I am Kaiser [Permanente, managed care consortium] I may not be able to see anything happening outside of the Kaiser world -- even though I have a great network. The one place that has access to and authority over all of that is the state health department.” The traditional line between public health and infection control is disappearing, as patients move across the continuum and take the full panoply of HAIs with them. As state collaboratives emerge linking the CDC, health departments, hospitals and outpatient settings, infection preventionists and their new-found allies may finally be in a fair fight with elusive HAIs. “We are helping [state health departments] --funding them, giving them people, training them,” Bell tells Hospital Infection Control and Prevention. “We are working as well as we can with them so we have a partner that can say, “I’m watching all of this, and that problem you're seeing in the hospital is actually related to this long-term facility or that dialysis center.’ It’s a very important piece.” The future of these critical collaboratives will inevitably depend on continued state and federal funding, likely with emphasis on the latter. With HAIs targeted early in the health care reform debate as “low-hanging fruit” for investment and action, there has been considerable federal allocation toward collaborations with state health departments. According to a report recently issued by the CDC and the Association of State and Territorial Health Officials (ASTHO), the states participating in many HAI collaborative projects benefited from the American Recovery and Reinvestment Act of 2009 funding. “Stakeholders expressed concern about the long-term sustainability of their programs,” the report states. “In cases where enduring funding streams are not available, stakeholders indicated that seed money, bonus payments, or facility improvement grants from third-party private payers may enable HAI efforts and support the implementation of cost-saving, self-sustaining programs.”