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The Association for Professionals in Infection Control (APIC) and Epidemiology is "encouraged" by the response it has received to a letter criticizing a patient safety group for snubbing infection control input in compiling a recent report.
APIC and the Society for Healthcare Epidemiology of America (SHEA) recently sent a jointly signed letter to John M. Eisenberg, MD, director of the Agency for Healthcare Research and Quality (AHRQ) in Washington, DC. (See Hospital Infection Control September, 2001 at www.HIConline.com.) At issue was a recently published AHRQ report Making Health Care Safer: A Critical Analysis of Patient Safety Practices, which was compiled by the Evidence-based Practice Center of the University of California, San Francisco/Stanford University. APIC and SHEA expressed disappointment that they were not consulted in the creation of the report, emphasizing that "infection prevention and control is an invaluable and integral component of the patient safety effort."
An immediate concern was that the recommendations would be adopted wholesale in health care policy and facilities nationwide. Although the report’s preface downplays the document’s intent, indicating that it is only a starting point in such efforts, there is evidence that, in fact, these recommendations are already being taken as "policy" by administrators, health professionals, insurers, and payers nationwide, APIC said in a press release.
"APIC members are seeking advice because their administrators are expecting them to comply with these recommendations," said Judith English, RN, MSN, CIC, APIC president, in a statement. "This puts infection control professionals in a real quandary — on one hand, they want to meet the expectations of their administrators; on the other, they know very well what works.
"Their role in outcomes monitoring, infection prevention, and surveillance is grounded in scientifically proven clinical practices. Many of these long-held standards of practice do not jibe with the new recommendations put forth in the AHRQ report."
According to the APIC release, Gregg Meyer, MD, director of patient safety for AHRQ, gave his response to the APIC/SHEA letter in a phone conversation with English and Christopher Laxton, APIC’s executive director. "It is . . . beyond the purview of the agency to endorse any single practice or group of practices," said Meyer.
"Our role, as a federal research agency, is to pull together the best evidence in a systematic fashion and make that available to guide wise decisions by others. The agency does not endorse that list, or any other list, which could be developed from the [UCSF/Stanford EPC] report," he said.
"We are very encouraged by our discussion with Dr. Meyer," said Laxton in a statement. "Both the interest AHRQ showed in our participating in future infection control work, and the collegial tone of the conversation, have given us good reason to expect a strong collaborative relationship between the agency and the infection control community going forward."