HAIs a high priority: Joint Commission gives infection prevention its own web portal
'We have both carrots and sticks.'
In yet another sign that infection control is becoming a national priority across a wide range of accreditors, regulators and state and federal agencies, the Joint Commission has created a new web portal to combine its full array of initiatives to prevent health care associated infections (HAIs).
"[We] have many moving parts that affect many aspects of health care," says Jerod M. Loeb, PhD executive vice president for healthcare quality evaluation at the Oakbrook Terrace, IL-based accrediting agency. "We have standards, performance measures, our center for transforming health care. The problem has been that they have all been located in silos."
The "HAI Portal" enterprise includes the Joint Commission Center for Transforming Healthcare, Joint Commission Resources, and Joint Commission International. The goal of the HAI Portal is to provide an integrated "kiosk" of HAI resources — including those that are free and for purchase — in one web view that is accessible through any of the Joint Commission related websites. Yes, there are Joint Commission related products for sale on the site, but Loeb says that was not the primary driver of the project.
"It was not built to be a marketing site," he says. "But just knowing a standard and knowing the elements by which a hospital might be surveyed doesn't give them all the other answers. So we have created a variety of tools and things that are available — many of which are free. If you are an accredited organization, for example, you can turn to our leading-practice library. If you have issues related to getting house staff to wash hands prior to central line insertion, for example, you can find dozens of things that other organizations that we accredit have identified as good solutions."
Other topics addressed on the site include, multidrug-resistant organisms, surgical site infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia. (See box, below.) The portal also includes resources on influenza, staff education and vaccinations.
Key HAI topics on new JC portal
The Joint Commission Healthcare Associated Infection (HAI) portal lists resources under three headings:
Infection Prevention and Control
HAIs by Setting
The new Joint Commission Healthcare Associated Infection (HAI) portal can be accessed at http://www.jointcommission.org/hai.aspx.
"HAIs are harmful for patients, costly for health care organizations and largely preventable," Loeb says.
Indeed, the Joint Commission has clearly separated itself from the old dogma of inevitable HAIs that reigned over health care epidemiology for decades.
"The mindset has changed radically," Loeb says. "This [new view of HAIs] is sort of a huge amalgam at the national level, and we have a very important responsibility as an accreditor. We have a pathway that can help organizations comply with best practices, and that is called the accreditation process."
The tightened focus on HAIs comes against the backdrop of unprecedented national activity on infection prevention.
"I think we were actually ahead of that curve with respect to the Joint Commission standards that have been on the books for years as well as our patient safety goals," he says. "Clearly it is a national issue, but we have been involved in this for a long, long time. I do think that the stakes have changed with respect to issues around incentive payment, value-based purchasing and hospital-acquired conditions. The national attention associated with anything about HAIs is high."
The long shadow of the CMS
Indeed, in the shadow of an increasingly active Center for Medicare and Medicaid Services (CMS) — the federal agency that gives it deeming authority to grant accreditation — the Joint Commission is not likely to become less aggressive in the survey process. (As we previously reported, the CMS will begin unannounced inspections of infection prevention and hospital employee health programs later this year.)
"We certainly have worked closely with them and we will continue to work closely with CMS as part of our deemed status relationship," Loeb says. "People and professional societies can preach it, but if nobody is validating whether [infection control] is done or not, things often don't change. We have an interesting perspective here because we have both carrots and sticks. This portal is, we believe, a large carrot."
Of course, what infection preventionists and other clinicians are hoping is that the multiple oversight groups and recommending bodies trend toward standardization and collaboration, unifying the rules and making the expectations crystal clear.
"At the national level there is an awful lot of collaboration going on," he says. "We hope that the easily accessible information on the HAI Portal will assist health care organizations, practitioners and caregivers to prevent HAIs in their organizations, practices and homes."
In that regard, while hospitals are expected to be the primary users, the Joint Commission designed the site to be accessible to a wide spectrum of health care settings and users.
"These are things infection preventionists, nursing home staff, health aides in a home health agency that we might accredit, all may want to know," he says. The HAI site may set the standard for similar web portals at the Joint Commission, Loeb adds.
"We decided to create a single door, a portal to get the [HAI] information that you might be seeking," he says.
However, in doing so, the Joint Commission was wary of creating a "menu" for standard compliance that could blunt critical thinking.
"If you open this portal and you are having a problem with a standard 'X,' you can utilize the tools," he says. "But we tried to be careful not to make this an artificial lock and key, forcing people to begin thinking they are doing 'X' because the Joint Commission says you have to comply with 'X.' We tried to get away from that mentality and mindset."
The Joint Commission HAI portal can be accessed at http://www.jointcommission.org/hai.aspx.