National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination
- Action Plan Development
- Phase 1: Acute-Care Hospitals
- Phase 2: Ambulatory Surgical Centers, End-Stage Renal Disease Facilities, and Increasing Influenza Vaccination Among Healthcare Personnel
- Phase 3 Long-Term Care Facilities
- Final list of HAI Action Plan Target and Metrics
- State HAI Prevention Plans
Action Plan Development
In recognition of healthcare-associated infections (HAIs) as an important public health and patient safety issue, the U.S. Department of Health and Human Services (HHS) convened the Federal Steering Committee-for the Prevention of Healthcare-Associated Infections (originally called the HHS Steering Committee, but was changed to reflect the addition of agencies outside of HHS). The Steering Committee's charge is to coordinate and maximize the efficiency of prevention efforts across the federal Government. Members of the Steering Committee include clinicians, scientists, and public health leaders representing:
- Administration on Aging (AOA)
- Agency for Healthcare Research and Quality (AHRQ)
- Centers for Disease Control and Prevention (CDC)
- Centers for Medicare & Medicaid Services (CMS)
- Food and Drug Administration (FDA)
- Health Resources and Services Administration (HRSA)
- Indian Health Service (IHS)
- National Institutes of Health (NIH)
- Office of the Secretary (OS)
- National Vaccine Program Office (NVPO)
- Office of Healthcare Quality (OHQ)
- Office of the Assistant Secretary for Planning and Evaluation (ASPE)
- Office of the Assistant Secretary for Public Affairs (ASPA)
- Office of the National Coordinator for Health Information Technology (ONC)
- U.S. Department of Defense (DoD)
- U.S. Department of Labor (DOL)
- U.S. Department of Veterans Affairs (VA)
The Steering Committee marshaled the extensive and diverse resources of the Department, formed public and private partnerships, and initiated discussions that identified new approaches to HAI prevention and collaborations. In 2009, the Office of Healthcare Quality (OHQ) was created by the Assistant Secretary for Health to support and carry out the Steering Committee's mandate to improve healthcare quality by preventing and eventually eliminating HAIs.
The Steering Committee, along with scientists and program officials across HHS, released the National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination (formerly the HHS Action Plan) with the incorporated public comments in 2009. The HAI Action Plan provides a roadmap for preventing HAIs in acute care hospitals, ambulatory surgical centers, end-stage renal disease facilities, and increasing influenza coverage of healthcare personnel.
In the first iteration of the HAI Action Plan, the Steering Committee focused on acute care hospitals where the scientific information on prevention and the capacity to measure improvement was most complete and where the associated morbidity and mortality was greatest. Thus, prevention of HAIs in acute care hospitals became the first phase of the HAI Action Plan.
Phase 1: Acute-Care Hospitals
Phase 1 of the HAI Action Plan addressed the most common infections in acute care inpatient settings and outlined a prioritized research agenda, an integrated information systems strategy, policy options for linking payment incentives or disincentives to quality of care and enhancing regulatory oversight of hospitals, and a national messaging and communications plan to raise awareness of HAIs among the general public and prevention strategies among healthcare workers:
- National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination (in sections)
- HAI Action Plan Target and Metrics lists the nine metrics with corresponding five-year goals to focus efforts in reducing healthcare-associated infections.
This HAI Action Plan includes five-year goals for nine specific measures of improvement in HAI prevention.
Phase 2: Ambulatory Surgical Centers, End-Stage Renal Disease Facilities, and Increasing Influenza Vaccination Among Healthcare Personnel
The healthcare and public health communities are increasingly challenged to identify, respond to, and prevent HAIs across the continuum of settings where healthcare is delivered. The public health model’s population-based perspective can increasingly be deployed to enhance the prevention of HAIs, particularly given the shifts in healthcare delivery from acute care settings to ambulatory and long-term care settings. The Steering Committee clearly articulated the need to maintain the HAI Action Plan as a “living document,” developing successor plans in collaboration with public and private stakeholders to incorporate advances in science and technology, shifts in the ways healthcare is delivered, changes in healthcare system processes and cultural norms, and other factors.
In late 2009, the Steering Committee approved an expansion of the HAI Action Plan, and through this expansion three new draft chapters or strategies were released in September 2010. Below are the revised draft chapters for Phase 2 for public comment:
- Ambulatory Surgical Centers (April 2012 Draft) [PDF - 270 KB]
- End-Stage Renal Disease Facilities (April 2012 Draft) [PDF - 484 KB]
- Influenza Vaccination of Healthcare Personnel (April 2012 Draft) [PDF - 358 KB]
These chapters comprised the second phase – Phase 2 – of the HAI Action Plan, extending its scope to the outpatient environment and addressing the health and safety of healthcare workers, as well as the risks of transmission of influenza from healthcare personnel to patients.
Phase 3: Long-Term Care Facilities
Since the publication of the original HAI Action Plan in 2009 which focused on the acute care setting, there has been awareness of the need for strategies to address HAIs in long-term care facilities. A growing number of individuals are receiving care in long-term care settings, such as skilled nursing facilities and nursing homes. The population in these facilities is requiring more complex medical care as a result of increased transitions between healthcare settings. These trends can create an increased risk for HAIs, which can worsen health status and increase healthcare costs. The Steering Committee chose to address HAIs in long-term care facilities for Phase 3.
Long-Term Care Facilities DRAFT Chapter: Public Comment Period is Closed.
The Office of Healthcare Quality public comment period on the Long-Term Care Facilities DRAFT Chapter of the National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination is now closed. We thank you for your comments. We will release the final version of the chapter in the fall.
- Long-Term Care Facilities DRAFT Chapter (July 2012) [PDF - 724 KB].
State Healthcare-Associated Infection Prevention Plans
The 2009 Omnibus Law required states receiving Preventive Health and Health Services (PHHS) Block Grant funds to certify that they will submit a plan to prevent HAIs to the Secretary of Health and Human Services by January 2010. HHS received plans from all 50 states, the District of Columbia, and Puerto Rico.
HHS Report to Congress: Healthcare-Associated Infections: FY 2010 State Action Plans
The report addresses the adequacy of State Healthcare-Associated Infection (HAI) Action Plans for achieving state and national goals for reducing HAIs. It responds to the joint explanatory statement to accompany H.R. 1105, the Omnibus Appropriations Law, 2009 (Public Law 111-8):
"…Each State plan shall be consistent with the Department of Health and Human Services' national action plan for reducing healthcare-associated infections and include measurable 5-year goals and interim milestones for reducing such infections: Provided further, That the Secretary shall conduct a review of the State plans submitted pursuant to the preceding proviso and report to the Committees on Appropriations of the House of Representatives and the Senate…"
National State-Specific HAI Summary Data Reports:
To see the current Standardized Infection Ratio (SIR) NHSN National Data report along with previous reports visit CDCs NHSNs National HAI Data Report page.
