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

“Leaders such as CNOs and CFOs are focused on metrics like outcomes, infection rates, and whether they are meeting value-based purchasing goals to optimize reimbursement,” says Lisa Petrilli, Head of The Medline Institute. “Meanwhile, clinicians working at the bedside are focused on the patients in their care and the processes they’re using to control infection day-to-day.”

The external web of stakeholders who influences infection control programs⁴

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 HAIs like MRSA and C. difficile.

“Through value-based purchasing programs, hospitals are rewarded based on the quality of care they provide and penalized for HAIs,” Petrilli says. “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 gain their support, it’s important for you to be as well.”

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 central line-associated bloodstream infection (CLABSI) rates.⁷

“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, talk 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. The Medline Institute has a ‘Leveraging Influence’ seminar that can help you formulate your plan and pitch and develop confidence in your approach.”

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.⁸ An ideal partner is someone who:

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

Along with identifying a senior-level advocate, it’s best to find champions among peer groups, according to Angela Newman, Medline Senior Director of Clinical Services. Champions most likely to succeed are those who are already intrinsically motivated and enthusiastic about the practices they promote.⁹

“Especially if you are new to infection prevention, you need leaders throughout the hospital to help you move the needle,” Newman says.

Team support is critical, given that infection can spread across multiple areas 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,” Newman 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.”