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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

(Not so) Great Expectations: Joint’s flu move too conservative

Conceding its current standards are out of touch with the growing pressure to protect patients by immunizing health care workers (HCWs) against seasonal influenza, the Joint Commission is proposing what appear to be generally more rigorous requirements that are open for comment until May 17th.

However, in attempting to align with federal public health agencies, the Joint Commission has set expectations that fall far short of great. Sure, there are more prescriptive proposed requirements, a call for ongoing improvement and an overall heightened sense of accountability. That said, the timeline for hospitals to achieve the stated goal of 90% immunization rates is the same year that current 3rd graders will graduate from high school: all hail the class of 2020.

Throwing in with the Healthy People 2020 goals by the Department of Health and Human Services (HHS), the Joint Commission has proposed a standard for field review that would give hospitals almost a decade to reach 90% HCW flu immunization levels.

To be fair, the Joint Commission is trying to stay aligned with the HHS and the Centers for Disease Control and Prevention, which sounds perfectly reasonable until you consider that the CDC has had a standing recommendation to immunize HCWs for flu for more than a quarter century. It hasn’t worked.

Thus, highly respected groups like the Association for Professionals in Infection Control and Epidemiology (APIC) and the Society for Healthcare Epidemiology of America (SHEA) have parted ways with the CDC, calling for flu shot mandates to protect patients from nosocomial influenza. For the record, the idea is to do this in 2011, not nine years hence.

An immune compromised patient in need of a hospital doesn’t have the luxury of such forward thinking. As it currently stands, if one of these patients – those for whom vaccination will not be fully protective -- are admitted to a typical U.S. hospital in the height of flu season about half the workers will not be immunized. They should be, and the Joint Commission should demand that they are if their work site is to be accredited with a stamp of quality care.

To comment on the proposed flu standards go to: