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Infection Control in Home Care: Developing an Infection Control Program to

Effectively Help Chronically Ill Individuals Avoid

Unplanned Hospitalizations

Thursday, June 18, 2015

Margherita Labson, RN, MSHSA, CPHQ

Executive Director, Home Care Program

Ed Smith, RN, MSN

Associate Director, Standards Interpretation

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Joint Commission Program

Learning Objectives

Construct an appropriate organization-wide

infection control program

Determine methods to engage patients/clients

in effective ways of preventing infections

Examine ways to credibly evaluate the results

of an infection control plan

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This webinar is approved for 1.0 Continuing

Education Credit from:

Accreditation Council for Continuing Medical

Education (ACCME)

American Nurses Credentialing Center

(ANCC)

American College of Healthcare Executives

(ACHE)

Continuing Education Credit

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CE/CME/CEU credit is available for the live audio only.

Credits will not be available for webinar replays.

In order to claim credit you must have: Individually registered for the webinar through The Joint

Commission website.

Listened to the webinar in its entirety. Only those listening live on

the day of the call will be eligible to receive credit. Only Joint

Commission accredited organizations will be eligible for the

continuing education credit.

Completed a post-program evaluation/attestation. A link to the

post-program evaluation/attestation will be sent to your

registered email 24-48 hours after the webinar. After completion

of the survey, you will receive a certificate available to download.

Obtaining Continuing Education

Credit

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The following staff and speakers have disclosed that

neither they nor spouses/partners have any financial

arrangements or affiliations with corporate organizations

that either provide educational grants to this program or

may be referenced in this activity:

Margherita Labson, RN, MSHSA, CPHQ, Executive Director,

Home Care Accreditation Program, The Joint Commission

Edward Smith, RN, MSN, Associate Director, Standards

Interpretation, The Joint Commission

Disclosure Statement

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Stakeholder Involvement

Leadership: Accountability and Commitment– Endorse resource allocation

– Leverage the value of the program

Champion: Empower and Enable– Knowledgeable expert

– Results oriented

Cross-divisional representation– Facilitator: provides roadmap for action

– Representatives from all affected operational areas

– Work is considered an essential component of

operational readiness

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Evaluating Risk

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Community Assessment

– Geographic risks

External Assessment: Resources

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External Assessment: Resources

Geographic risks

Seasonal considerations

Local partners

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Internal Assessment: Resources

Capitalizing on your data

Vulnerabilities – Population served

– Services provided

– Referral sources

Risks posed by staff– Behavior economics

– Contracts

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Prioritizing Risk

External Environment

Patient/Client Chronically Ill

Population

Internal Environment

Patients/Client At risk

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Real World Example

Home Medical Equipment Organizational Centric View

Assumption Chronic Illness-External info

– Driven from intake information

– Informed by health care industry

Defined Attributes-Population

– Demographics

– Population characteristics

– External environment

Contractual Requirements-Internal info

– Payer base: HMO, PPO, FFS, Commercial

– Service delivery frequency and methodology

Operational Resources-Internal info

– Demographics of Staff

– Staffing capability

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Analyzing Priorities

Risks Identified

Respiratory related illness

– Seasonal influenza

– Cold virus

– Pneumonia

– Norovirus

Wound infection

– Staph infection

– Entercoccal infection

– MRSA

Implications for the plan

Influenza prevention program

– Vaccination program

– Educational efforts

– Measure and manage

Respiratory Care Program

– Staff education: PPE, time off

– Recognize, respond and replace

– Work with payers to promote

healthy behaviors

Control bacterial contamination

– Add norovirus policy

– Cleaning/disinfecting equipment

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Useful Tools Securing Leadership Buy In:

Opportunities and Threats

Opportunities Threats

↓rate of admission >5% =

premium rates

Improved resource utilization

and savings

Improved operational efficiency

Longer length of stay for

patients

Compelling data to attract new

customers

Improved patient satisfaction

and loyalty

Readmission for pneumonia >2%

=threatens contract

Patient satisfaction ↓ with repeat

admissions

Uncompensated supply

utilizations

Staff at higher risk for acquired

infection

↑ overtime if staff become ill

More difficult contract renewal

discussions

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Approver: one who can authorize and move the

boulders, sponsor or business leader whose approval

is required

Resource: an expert with skills/information needed

for a fixed period of time

Member: full-time team members who know the

work to be done

Interested Party: those who have a need to know

about the project

Right Representation: ARMI Analysis

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Designing a Plan

Professional standards and recommendations

Creating smart goals

Data driven management

Practical examples

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Managing Chronic Disease:

–COPD

–Diabetes

–Rheumatoid Arthritis

–Neuromuscular disorders

–Dementia spectrum

–Heart Disease

A Key Component of the Triple Aim

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Generational Differences:– Matures

– Boomers

– Gen Xers

– Millennials

Behavioral Economics– Purchasing power, high deductibles and co-pays

– Predictive analytics

Factors Influencing Engagement– Health care consumer as a partner

– Redefining the role of health care provider

Attributes of Health Care Consumers

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Patient/Client Centered Care

Right Tool for the Right Job

Relational vs Transactional

Working with provider partners and

payers

Methods of Engagement

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Consumer awareness linking out of pocket

savings to infection prevention activities

Programs w/Payers to incent patients

towards infection prevention

Leadership and staff accountability for

infection prevention

Physician-provider affiliated programs

Practical Applications

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Evaluating Program Results

Evaluating against the goal

Reporting and trending

Getting to the root cause of the issues

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Summary

Buy in is greater if plan is relevant

Patient partnership

Credible evaluation sustains

improvement

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Questions?

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Home Care Team ContactsJoint Commission Home Care Program

Help Desk: 630-792-5070 or homecare@jointcommission.org

www.jointcommission.org/accreditation/home_care.aspx