Introduction	Page 28
Table 4. Departmental & HHS Operating Division Roles and Activities in Implementing the National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination	Page 30
Figure 1. Organizational Structure of the HAI Steering Committee	Page 31
Table 5. HHS Action Plan (2009) Priority Areas and Five-Year Goals	Page 32
Changing Landscape	Page 36
Ten Themes for Translating Strategy to Action	Page 46
Conclusion	Page 49

Part 3: Phase One - Acute Care Hospitals

Introduction		Page 50

	Chapter 1: Research
	Introduction	Page 51
	Progress Made in HAI Prevention Research, FYs 2008-2010	Page 52
	Current State of the Art, Identified Gaps in Knowledge and Practice	Page 56
	Long Term Prioritization, Coordination, and Evaluation of Research Efforts	Page 68
	Conclusion and Vision for the future: Research as the Foundation of a Learning Healthcare System	Page 70
	Table 6. Status of Identified Priority Research Projects in the 2009 HHS Action Plan	Page 72

	Chapter 2: Information Systems and Technology
	Introduction	Page 73
	Maintaining the Foundation for HAI Data Integration and Interoperability	Page 75
	Coordination of Efforts: Interagency Working Group	Page 76
	Work Group Goals, Tasks, and Operations	Page 77
	HAI Data and Data Inventory	Page 80
	Integrating Sources of Data	Page 81
	Challenges and Opportunities	Page 82
	Conclusion	Page 83

	Chapter 3: Incentives and Oversight
	Introduction	Page 84
	Regulatory Oversight	Page 84
	Value-Based Purchasing Financial Incentives	Page 87
	Table 7. Payments based on Medicare-severity diagnosis-related group assignment and Present on Admission Status	Page 89
	Transparency and Associated Incentives	Page 106
	Related Initiatives Addressing HAIs	Page 110
	Conclusion	Page 120

	Chapter 4: Outreach and Messaging
	Overview	Page 121
	Goals	Page 122
	Target Audience	Page 122
	Table 8. HAI Target Audiences and Key Messages, Tactics, and Materials/Products	Page 124
	Partnership Development	Page 129
	Evaluation	Page 129
	Activities of Participating HHS Operating and Staff Divisions and Other Federal Agencies	Page 130
	Conclusion	Page 134

Part 4: Phase Two - Outpatient Settings and Influenza Vaccination of Health Care Personnel
	Chapter 5: Ambulatory Surgical Centers
	Introduction	Page 136
	Background	Page 136
	Progress Made	Page 138
	Remaining Needs and Prevention Opportunities	Page 142
	Next Steps: Collaborations for Shared Solutions	Page 145
	Conclusion	Page 150
	Table 9. Summary of Literature Review of Surgical Site Infection Surveillance Practices Conducted in Non-Acute Care Settings	Page 151

	Chapter 6: End-Stage Renal Disease Facilities
	Introduction	Page 152
	Background	Page 152
	Healthcare-Associated Infections in ESRD	Page 154
	Prevention Priorities Recommendations in ESRD Facilities	Page 157
	Metrics and Evaluation	Page 164
	Table 10. Five-Year National Metrics and Evaluation Targets	Page 164
	Incentives and Challenges	Page 169
	Information Systems and Technology	Page 172
	Future Directions	Page 174
	Summary of Recommendations	Page 177
	Conclusion	Page 179
	Table 11. HHS Ongoing Collaborative Projects Related to Reducing HAIs in ESRD Facilities	Page 180

	Chapter 7: Influenza Vaccination of Healthcare Personnel
	Introduction	Page 186
	Figure 2. Self-Reported Influenza Vaccination Coverage Levels Among Selected U.S. Adult Populations, 2000-2009	Page 187
	Background	Page 188
	Addressing HCP Vaccination Rates	Page 193
	Measurement of Influenza Vaccination among Healthcare Personnel	Page 196
	Coordination of Efforts: Interagency Working Group	Page 197
	Working Group Goals and Tasks	Page 198
	Working Group Projects	Page 201
	Research Gaps	Page 202
	Challenges and Opportunities	Page 203

Part 5: Conclusion
	Chapter 8: Conclusion
	Coordination of Efforts	Page 205
	Conclusion	Page 206

Table of Contents