Healthcare facilities have constant activity due to contractor employees performing necessary work. This includes elevator technicians, painters, flooring contractors, plumbers, electricians and more, all without functional knowledge of how their work can negatively affect an immune-compromised patient. More than 50 percent of all Aspergillus, spp.-related hospital-acquired infections (HAIs), are contracted due to common molds attached to dust particles caused by maintenance or construction-related work.

In an effort to reduce the overwhelming number of HAIs that occur annually, the Centers for Disease Control and Prevention recommends that all personnel working in a healthcare facility have infection-control training. The Centers for Medicare & Medicaid Services even cites hospitals for not training everyone who works in the hospital.

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Current impact of HAIs

An alarming 5 percent of all hospital stays result in readmissions due to infections that patients acquire in the healthcare facility. HAIs are widely seen as preventable and often caused by hospital conditions or human error. Each year, HAIs are costing healthcare facilities more than $30 billion and are, more importantly, claiming 99,000 lives or 271 deaths each day. To reduce the risk of HAIs, which are now claiming more lives annually than AIDs, breast cancer and car accidents combined, all contractor employees and hospital employees must have infection control training.

Meeting the requirements

The manner in which most contractors and hospitals attempt to meet these requirements and improve quality are fraught with challenges.

• Employees are busy, and it is hard to pull them away from the job site for training.
• The quality of the training is variable.
• Many facilities fail to document competency.
• It is difficult to train all employees during all shifts.
• Hospitals may train one group of workers and have different people show up at the work site.
• Hospitals may train employees in a specific area and the have workers float from other units.
• Live training with infection control personnel is time-consuming and expensive.

Imagine the following scenario in your facility

Contractor employees are working near a radiology suite without proper barriers and engineering controls. As they work, they disrupt a debris cart-cover made of fabric that has not been cleaned in more than a month. The bacteria and fungi that had been carried on the cover now travel through the air and attach to medical instruments, lab coats and other items that will come into contact with patients throughout the hospital. Although the contractors were following protocol, they did not know how infections are spread and consequently did not take the necessary precautions to protect patients. Even the smallest amount of migrating dust can severely harm patients, especially those who have weakened immune systems, and result in the development of an HAI or even death.

Checklist of best-practice training protocols

Now that we have reviewed the impact of the quality problem and the challenges to provide effective training to mitigate risk, what are the characteristics of a best practice training process?

• E-learning video modules increase information retention by up to 60 percent.
• Post tests document competency as a result of the training.
• E-learning allows training to be available 24/7 to cover all shifts, new employees, etc.
• Use of “cloud” storage allows for readily available documentation of training and competency.
• Cloud-based video training allows for a consistent training message to be delivered to each participant.
• Cloud-based e-learning programs are generally contractor paid and then made available to hospital employees at no charge.
• Look for a company willing to provide grants to the hospital to support initiatives to reduce HAIs.

Quality tied to finances

It has always been the right thing to do to operate our facilities in the highest quality fashion. The importance of reducing HAIs and lowering readmission rates is heightened because of the reimbursement changes that are part of healthcare reform. Poor quality now results in lower reimbursements and penalties. Following best-practice training protocols will help mitigate the risk of quality issues and provide a safer, more cost effective environment for those we serve.

Kevin L. Shrake ([email protected]) is a 35-year veteran of healthcare, a board-certified fellow in the American College of Healthcare Executives and a former hospital CEO. He currently serves as the executive vice president/chief operating officer of MDR, based in Fresno, California.