2008 Salary Survey Results
2008 Salary Survey Results
Rock and roil: IPs riding out turbulent economic times
Field's move to forefront of patient safety movement means job security
Infection preventionists have been drawn into the white-hot national spotlight on health care-associated infections in recent years, sometimes being accused by overzealous patient advocates as being as much a part of the problem as the solution.
But the other side of that higher profile is that that it has put IPs — albeit sometimes painfully — at the front and center of the patient safety movement as an economic crisis strikes the nation. This is no time to be stuck in a silo, calculating benchmark ranges.
On the contrary, infection prevention has been the subject of so many demands and mandates in recent years, that there actually is a shortage of people to fill IP positions, says Barbara Soule, RN, MPA, CIC, practice leader for infection control services at Joint Commission Resources Inc.
"As the job is becoming more recognized and there are more demands being placed on the field, we need more people to carry out all of this work," she says. "Infection control has been in some cases — not all — understaffed for a long time. Now with the profession in the public eye and all of the new regulations and the continuing problems with infection, we need people who are well trained and we need enough of them to accomplish the work. I think that is one of the main reasons for the shortages."
Taking nothing for granted
Still, nobody is taking anything for granted. Relatively recession proof in any economy, hospitals are feeling the considerable heat of this meltdown.
"Hospitals have always been challenged to meet the budget, and that is not going to go away," said Janet Frain, RN, CIC, CPHQ, CPHRM, 2008 President of the Association for Professionals in Infection Control and Epidemiology. "Infection prevention is a major patient safety issue for all of the institutions, [but] the CEOs are faced with a huge struggle when it comes to funding. There are multiple priorities within the organization. We hope we have the commitment of the C-Suite to continue to fund and resource infection prevention, but I don't think anybody is very confident at this point that any of us have a job when we go back to work. There are challenges facing the administrative suite, and sometimes you have to weigh in on the side of the bedside caregivers or what department may have the most need of a solution."
IP success stories usually include a credit line to administrative support, both through resources and institutional vision, Frain noted at a recent news conference on infection prevention. "When everybody is on the same path, dramatic change happens, but there is no crystal ball for this economy or [any certainty] how it is going to affect the infection preventionist in the facility."
In a sense, it's the same old story being played out on a larger stage. IPs always have had relatively good job security due to hospital accreditation requirements. With those standards morphing into national regulations and mandates, that job security seemed ironclad until this "all-bets-are-off" recession began — actually about a year ago, we are now told. During that year, IPs saw only modest wage growth for the most part, but appear about as well positioned as any one in health care to ride the situation out, according to the 2008 salary survey by Hospital Infection Control & Prevention.
Unchanged from 2007, the median salary for survey respondents was in the $60,000 to $69,999 range, according to the annual salary survey by HIC. The 2008 survey of 195 IPs found that the median age range of respondents was 46-50, a range younger than the 2007 median age range of 51 to 55 years old. A broader demographic shift may be evidenced there, as the old guard retires and contributes to the aforementioned IP shortage.
In salary percentage breakdowns, 6% were making $40,000 to $49,999; 19% were paid $50,000 to $59,999; and 27% had salaries in the $60,000 to $69,999 range. Rounding out the lows and highs, 2% were making $30,000 to $39,999; and 18% were in the $70,000 to $79,999 range. Fifteen percent drew salaries between $90,000 and $129,999.
The 2008 survey found 51% of respondents drew wage hikes in the 1% to 3% range over the previous year. However, 20% of respondents drew raises of 4% to 6%, and 4% of respondents were given a raise in the 7% to 10% range. Still, 20% reported no raises for the period, up from the 14% that reported no wage growth in 2007. The median-size hospital for respondents was 201-300 beds, with 22% working in facilities of fewer than 100 beds and 15% working in hospitals with 500 beds or more.
Whatever the size of the hospital: the survival mantra for IPs is that prevention pays. "I think it is very important for us to keep in mind that when you prevent infections, you are saving money," Denise Cardo, MD, director of the division of healthcare quality promotion at the Centers for Disease Control and Prevention, said at the press conference. "When you look at Medicare, the federal payment system, [preventing infections means] saving money. When we think about really changing the health care system — and making it safer and less expensive in the United States — one of the low-hanging fruits is the prevention of health care-associated infections."
It is clear that message has translated to all manner of new oversight and reimbursement pressures to keep infection control funding flowing. But the ultimate incentive, especially during the harshest of economic times, is that infection prevention is about reducing suffering and saving lives. Being front in center in the patient safety movement has its responsibilities. Hospitals that cut costs on infection prevention do so at their patients' peril.
"As we face these challenging economic times, our senior leadership in the hospitals keep in the mind that — regardless of economic conditions — it is about the patient first," said Terri Straub, RN, MBA, vice president of quality and patient safety at the Greater New York Hospital Association in NYC.
National recession hits hospitals
Fewer patients seek care, more cannot pay
Typically considered a safe haven in an economic storm, hospitals are starting to feel the impact of the national recession. Fewer patients are seeking hospital care while at the same time a growing proportion of patients need assistance paying for care, according to a new report from the American Hospital Association. The report also noted that hospitals — which employ 5 million people nationwide — could be facing uncertain times as their financial health falters and ability to borrow funds for improving facilities and updating technology is squeezed.
The report is based on survey results from 736 hospitals and information from DATABANK, a web-based reporting system used in 30 states to track key hospital trends. Many hospitals are beginning to see the effects of the economic downturn, with more than 30% of survey respondents reporting a moderate to significant decline in patients seeking elective procedures, and nearly 40% of respondents reporting a drop in admissions overall. The majority of hospitals surveyed also noted an increase in the proportion of patients unable to pay for care. Uncompensated care was up 8% from July to September vs. the same period last year, according to the report. Like many institutions, hospitals rely on investment income as one of the ways to help make ends meet, especially since government payers do not cover the costs of care. However, recent turmoil in the stock market has turned investment gains to losses, further worsening hospitals' financial condition.
At the same time, Medicaid expenditures — the largest and fastest growing portion of many state budgets — increase even faster during economic downturns as enrollment grows and state tax revenues drop. State and federal budget difficulties raise worries about potential cuts to Medicare and Medicaid, which cover half of the patient care provided by the nation's hospitals. Financial stress is forcing hospitals to make or consider making cutbacks, including cutting administrative costs (60%), reducing staff (53%) and reducing services (27%), among the hospitals surveyed.
(Editor's note: The complete survey results can be found at www.aha.org.)
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