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State HAI Plan

August 19, 2009 Web Conference
Slides also available for download in PDF format Healthcare-Associated Infections: State Plans (2.70 MB / 33 pages)

Slide 1
Healthcare-Associated Infections: State Plans
Department of Health & Human Services
Office of the Secretary
Office of Public Health & Science
Web Conference
Wednesday, August 19, 2009

Slide 2
Goals

• Provide background and guidance regarding the development of state plans
• Hear/Discuss questions and comments related to the development of state plans

Slide 3
Agenda

• Background
• HHS Action Plan: Development and Implementation
• Recovery Act Funds Targeting HAIs
• Healthy People 2020
• State Plans: Legislation and Development
• Questions

 

Slide 4
Healthcare-Associated Infections (HAIs)

• What are they?
  • Bloodstream infections, urinary tract infections, pneumonia, surgical site infections
• The Problem
  • 1.7 million HAIs in hospitals—unknown burden in other healthcare settings
  • 99,000 deaths per year
  • $26-33 billion in added healthcare costs
• HAI Prevention
  • Implementing what we know for prevention can lead to up to a 70% or more reduction in HAIs

Slide 5
Increasing Needs for Public Health Approach Across the Continuum of Care

Acute Care Facility - Home Care - Long Term Care Facility - Outpatient/ Ambulatory Facility

Slide 6
HHS Action Plan to Prevent Healthcare-Associated Infections
Development and Implementation

Slide 7

cover of; HAIs in Hospitals

Slide 8
GAO Report: Recommendations for HHS

• Improve central coordination of HHS-supported prevention and surveillance strategies
• Identify priorities among CDC guidelines to:
  • Promote implementation of high priority practices
• Establish greater consistency and compatibility of the HAI-related data across HHS systems to:
  • Increase reliable national estimates of HAIs

Slide 9
HHS Steering Committee for the Prevention of HAI

• Charge: Develop an Action Plan to reduce, prevent, and ultimately eliminate HAIs
• Plan will:
  • Establish national goals for reducing HAIs
  • Include short- and long-term benchmarks
  • Outline opportunities for collaboration with external stakeholders
  • Coordinate and leverage HHS resources to accelerate and maximize impact

Slide 10
Tier One Priorities

HAI Priority Areas

• Catheter-Associated Urinary Tract Infection
• Central Line-Associated Blood Stream Infection
• Surgical Site Infection
• Ventilator-Associated Pneumonia
• MRSA
• Clostridium difficile

Implementation Focus

• Hospitals

*Tier Two will address other types of healthcare facilities

Slide 11
Steering Committee Working Group Structure

HHS Steering Committee for the Prevention of HAI

Prevention and Implementation Lead: CDC
Research Lead: AHRQ
Information Systems and Technology Co-Leads: OS/ONC & CDC
Incentives and Oversight Co-Leads: CMS
Outreach and Messaging Lead: OS/OPHS

 

Slide 12
HHS Action Plan

• Initial version issued in January 2009
• Public comment received in February 2009
• Revision finalized in June 2009
• HHS Action Plan Website www.hhs.gov/ophs/initiatives/hai

Slide 13
Stakeholder & Public Engagement

• Hold five stakeholder/public engagement meetings
  Washington, DC – Tuesday, June 30 (National Level)
  Denver, CO – Saturday, July 25 (Regional/State Level)
  Chicago, IL – Thursday, July 30 (Regional/State Level)
  Seattle, WA – Thursday, Aug 27 (Regional/State Level)
  Chicago, IL – Tuesday, Sept 22 (Regional/State Level)
• Engage professional and public stakeholders in the HHS Action Plan
• Request input on priorities and strategies
• Additional Information www.hhs.gov/ophs/initiatives/hai

Slide 14
American Reinvestment and Recovery Act Funds
Preventing Healthcare-Associated Infections

Slide 15
Building State Programs to Prevent HAIs

• Project Description:
  • Create and expand state-based HAI prevention collaboratives
  • Build a public health HAI workforce in states
  • Enhance states abilities to assess where HAIs are occurring
• Agency Lead: CDC
• Collaborating Agencies: AHRQ and CMS
• Funds Source & Amount: ARRA ($40 M)
• CDC HAI Recovery Act Website www.cdc.gov/nhsn/ra

Slide 16
New Ambulatory Surgery Center Infection Instrument

• Project Description:
  • Nationwide application of a new infection control survey instrument (designed by CMS & CDC)
  • Use of new tracer methodology
  • Use of multiple-person teams for ASCs over a certain size or complexity, and greater frequency than the current 10-year average inspection frequency (goal 3 years)
• Agency Lead: CMS
• Collaborating Agencies: CDC
• Funds Source & Amount: 2-year funding with ARRA grant dollars of $1 million in FY09 and the remaining $9 million in FY10

Slide 17
Healthy People 2020:
Defining the Nation’s Health Objectives

Slide 18
Healthy People: What is it Now?

• A comprehensive set of national ten-year health objectives
• A framework for public health priorities and actions
• Guided health policy decisions for 3 decades
• www.healthypeople.gov

Slide 19
Draft Mission Statement

• Healthy People 2020 strives to:
  • Identify nationwide health improvement priorities;
  • Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress;
  • Provide measurable objectives and goals that are applicable at the national, state, and local levels;
  • Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge;
  • Identify critical research, evaluation, and data collection needs.

Slide 20
Healthy People 2020 – Phase IINew Topic Areas

• Access to Health Services
• Adolescent Health
• Children’s Health
• Genomics
• Global Health
• Older Adults
• Healthcare-Associated Infections
• Quality of Life
• Social Determinants of Health
• Blood Disorders and Blood Safety
• Healthy Places
• Preparedness

Slide 21
State Plans
Legislation and Development

Slide 22
State Plan Legislation

• Fiscal Year 2009 Omnibus Bill:
• Requires states receiving Preventive Health and Health Services (PHHS) Block Grant funds to certify that they will submit a plan to the Secretary of HHS not later than January 1, 2010
• State plans will:
  • Be consistent with the HHS Action Plan
  • Contain measurable 5-year goals and interim milestones for preventing HAIs
  • Be reviewed by the Secretary of HHS with a summary report submitted to Congress by June 1, 2010

Slide 23
PHHS Block Grant Congressional Intent

Slide 24
State Plan Template

• Provides framework to ensure progress towards five-year national prevention targets as described in the HHS Action Plan in the following areas:
  • Develop or Enhance HAI Program Infrastructure
  • Surveillance, Detection, Reporting, and Response
  • Prevention
  • Evaluation, Oversight, and Communication

Slide 25
State Plan Template

Slide 26
State Plan Template

• State HAI Plan Template provides choices for developing or enhancing state HAI prevention activities
  • States can choose to target different levels of HAI prevention efforts indicated by checking appropriate boxes. This can serve as the state’s HAI plan for submission.
  • The template is designed to be flexible and accommodate states at different levels of planning.
  • If your state has an existing plan, you may choose to incorporate that plan into the template or submit the existing plan in place of the template.
• CDC will be providing relevant training and technical support for Recovery Act HAI programs
• State Plan Template www.cdc.gov/ncidod/dhqp/stateHAIplan.html

Slide 27
Timeline

• July 1, 2009 – All States certified that they will submit a plan to CDC and therefore received their full Block Grant funding
• August 19, 2009 – HHS/OS call with States and partners
• October 19-20, 2009 – CDC to host ELC Recovery Act grantee meeting in Atlanta, GA
  • State plans will be part of the discussion
• January 1, 2010 – State plans due to HHS/OS
• January 1, 2010 through June 1, 2010 – HHS Secretary to conduct a review of the State plans with CDC technical support
• June 1, 2010 – HHS Secretary provides report to the Committees on Appropriations of the House of Representatives and the Senate

Slide 28
Submission Process

• Email to haistateplans@hhs.gov
• Mail to:
• HAI State Plans
  Department of Health & Human Services
  Office of the Secretary, Office of Public Health & Science
  200 Independence Avenue SW, Room 716G
  Washington, DC 20201
• Plans must be submitted by January 1, 2010

Slide 29
HHS HAI Programs & Resources to Support States

Division of Healthcare Quality Promotion (CDC)
www.cdc.gov/ncidod/dhqp

Healthcare Infection Control Practices Advisory Committee Guidelines (CDC)
www.cdc.gov/ncidod/dhqp/hicpac_pubs.html

National Healthcare Safety Network (CDC)
www.cdc.gov/NHSN and nhsn@cdc.gov

Prevention of Central Line-Associated Bloodstream Infections: Audio Feature (AHRQ)
www.healthcare411.ahrq.gov/featureAudio.aspx?id=939

Slide 30
HHS HAI Programs & Resources to Support States

Quality Improvement Organizations (CMS)

Background

Medicare Quality Improvement Community (MedQIC)
www.qualitynet.org/medqic

How to Partner with QIOs
QIO Synergy
www.qiosynergy.org

All Medicare Quality Improvement Work
CMS Quality of Care Center
www.cms.hhs.gov/center/quality.asp

Slide 31
Points of Contact & Important Links

Questions?
Office of Public Health & Science
Office of the Secretary, Department of Health & Human Services
haistateplans@hhs.gov

HHS Action Plan to Prevent Healthcare-Associated Infections
www.hhs.gov/ophs/initiatives/hai

State HAI Plan Template
www.cdc.gov/ncidod/dhqp/stateHAIplan.html

Slide 32
What Happens if a Plan is Not Submitted?

• At this time, no penalties for non-submission exist
• States are strongly urged to follow this timeline because the state plans:
  • Should be linked to ARRA funded HAI activities, which do have a wide range of accountability measures in place
  • Will assist the Federal Government in identification of future funding opportunities and opportunities for technical support to States

Slide 33
Questions?

Infection Control Topics

• Infection Control Home
• Healthcare-Associated Infections
• Protecting Patients
• Protecting Healthcare Workers
• Infection Control Guidelines
• Infection Control A-Z
• About DHQP