HHS Action Plan to Prevent Healthcare-Associated Infections: Outreach and Messaging
I. Introduction
As noted in earlier sections, healthcare-associated infections (HAIs) are a significant cause of mortality and morbidity each year in the U.S. To address this important public health and patient safety issue, the Department of Health and Human Services (HHS) will encourage pro-active efforts on behalf of all facets of the healthcare system, as well as consumers, to take important preventive steps.
To this end, HHS will engage in state of the art methods of communication with stakeholders that include providers, purchasers, professional associations, governmental agencies, academia, and the public to raise awareness to the key prevention actions outlined within the plan on or around January 2009.
Communications methods using various channels of communications and state of the art best practices using risk communication and social marketing will include:
- Raising awareness to the importance of addressing HAIs;
- Empowering consumers with tools and knowledge to be effective patient advocates for prevention;
- Helping healthcare professionals focus their attention on preventive steps that will yield the greatest benefits; and
- Sharing the overall progress of the nation in reducing national rates of HAIs.
II. Primary Objective of the Communications Campaign
Reduce healthcare-associated infections by formulating goals and interim benchmarks that aim to:
- Increase dissemination of key messages about practices to prevent healthcare-associated infections to target audiences.
- Increase knowledge and awareness of key prevention practices to reduce healthcare-associated infections among providers, consumers, media, and general public.
III. HHS Secretary’s Goal on the Prevention and Elimination of HAIs
The HHS Secretary has issued a call to action to reduce healthcare-associated infections. To do this he has established a plan that the government, the healthcare industry, and consumers can stand behind to achieve this common goal. Furthermore, HHS aims to empower consumers with information to help to prevent HAIs.
The communication campaign will focus on these mutual goals and the primary objectives outlined above. Some details about the campaign are found below:
- Proposed Date
January, 2009 HHS Action Plan Released
- Proposed Theme
Reducing, preventing, and working towards the eventual elimination of the great majority of healthcare-associated infections
- Target Audiences Include
- Healthcare Provider Groups
- CEO/ Management/Leadership in the Hospitals
- Healthcare Workers – Practicing doctors, nurses, etc.
- Infection Preventionists (IPs) – IPs set hospital policy and are responsible for taking the information to staff in service
- Hospitalists
- Allied Health Professionals
- Janitorial and maintenance workers who could be at risk for acquiring an HAI
- Quality Improvement Organizations (QIOs). (For additional information, see “Incentives and Oversight” The Centers for Medicare and Medicaid Services (CMS) has just launched a new three-year QIO contract cycle, whereby QIOs will be focusing on infection control in the hospital setting. Their particular focus will be on Methicillin-resistant Staphylococcus aureus (MRSA) prevention. {HHS plans to coordinate the communication messaging with the QIOs as part of their inpatient staph-infection prevention/reduction efforts. As background, the QIOs are partnering with specific hospitals in each state, so their reach would be more towards providers than consumers. Each QIO will be able to devise localized methods for communication, in coordination with CMS/HHS’ National Patient Safety Initiative and this campaign.}
- Consumer Groups
- Patients
- Caregivers (Including family and friends)
- Patient Advocacy Groups
- Public Health Community
- Public health agencies and organizations at the local, state, regional, and federal levels
- Graduate schools of public health
- Other professional and allied health schools
- Public health laboratories and associations
- Academia
- Healthcare institutions
- Healthcare instructors
- Curriculum developers
IV. Partnership Development
Recognizing that reducing HAIs nationally is a shared responsibility of government and the healthcare industry, HHS must develop a strong partnership network to amplify prevention messages, promote implementation of recommended practices, and monitor progress at the national, regional, and local level. In addition, consumers can play an important role in advocating for their and other’s safe health care. Many of the outreach and messaging activities is currently happening within the various operating and/or staff divisions of HHS. As such, the key focus will be to coordinate and leverage existing agency efforts.
Pivotal to the success of the HAI campaign strategy will be the ability to personalize prevention messages in a way that it can be embraced by all segments of society so as to bring about a shift in prevailing social norms. Some recommendations on the messaging strategy:
- Messages should be tailored appropriately to the audiences that are being targeted (e.g., healthcare professionals and consumers), keeping unique populations and subgroups in mind.
- The messaging should be focused and consistent.
- The messaging should consider the impacts and/or benefits to the target audience, i.e., why they should care, and why it is important they have and use this information.
A. Potential Partners
Partners representing all sectors are encouraged to participate in the HHS Campaign. First tier partners will primarily be those organizations who have been active and/or have synergistic efforts currently underway with their constituencies. Partners should include professional associations for healthcare providers, large hospital systems, associations that deal with infection control and patient safety, health officials (public sector organizations), consumer groups, health care institutions, and other public health organizations.
B. Benefits of Partnering with HHS
Partner assistance and support will help the nation achieve and sustain long-term success in preventing and reducing HAIs. Partnering with HHS offers many benefits, including:
- Public recognition as an HHS partner;
- Scientific expertise of HHS;
- Sharing information and resources with the broad representation of HHS Operating and Staff Divisions;
- Use of HHS educational and promotional materials;
- Use of HHS national media campaign products;
- Improved health and welfare of all Americans;
- Improved quality of patient care; and
- Reduction of unnecessary healthcare costs.
There are many opportunities for partners to get actively involved with the initiative campaign. Suggested recommended actions include:
- Messages should be provided to healthcare consumers/patients.
- HHS and its partners should display posters and other materials in high visibility areas.
- It is important to distribute to healthcare providers detailing sheets reviewing appropriate prevention guidelines.
- Local communities and partners should develop local level appropriate HAI prevention campaigns, including educational products.
- HHS, in conjunction with its regional offices and partnering with state health agencies, should provide assistance to local level campaigns in producing educational materials or sponsoring events.
- It will be critical to deliver presentations on prevention to interested parties. HHS and its partners should actively share information with local media outlets to amplify messages and the importance of addressing the issue.
V. Messaging
The messaging for the overall campaign should be appropriate to the level of the audience and use the principles of risk communication and social marketing. If used by HHS, all messages should have the appropriate level of agency clearance.
Other messaging should be developed by HHS and be part of the public domain for shared used by professional groups and audiences.
A. Top Ten Messages for Outreach Strategy
HHS along with its partners should disseminate the following priority messages:
- Many healthcare-associated infections are preventable.
- A systemic approach to reducing the transmission of disease can be more effective than disease-specific approaches.
- Developing and supporting the conduct of basic and translational studies to address the gaps in the science in this field will allow generation of additional strategies that can be used to reduce the risks of HAI transmission.
- It will take a strong partnership between federal and local/state governments and communities to truly help prevent HAIs. HHS is committed to this partnership and many of its agencies are and will be involved.
- The education of best practices for providers and other healthcare personnel is critical to prevent HAIs.
- Specific metrics and national targets have been developed by HHS in concert with national experts on controlling infections.
- Educating patients on HAIs and how to prevent them will be a critical part of the national effort.
- An informed media can help promote the education of the American public about the need to prevent HAIs and what HHS and its partners are doing.
- Preventive steps to control and prevent HAIs are cost-effective and will save many lives and reduce disability for Americans.
- The time to act on HAIs is now, and HHS and its partners are committed to working closely with providers, health systems, community leaders, and governments to help prevent HAIs.
B. Top 5 Campaign Messages
The HICPAC, in partnership with HHS, has developed the top five messages for a healthcare worker and consumer awareness campaign. These messages are consistent with important areas of prevention focus currently identified for HAI. Detailed examples of the following overarching messages can be found under Education and Training Tools at http://www.cdc.gov/ncidod/dhqp/index.html .
- Hand hygiene
- Healthcare personnel vaccination
- Patient vaccination
- Prompt removal of catheters and other devices
- Antimicrobial stewardship
C. Promotional Activities
The Department will organize national and regional activities to foster implementation of the Action Plan and educate partners about the Campaign’s key messages at different levels. HHS will also promote its message through the ten Regional Offices for distribution to states, territories, and communities in their jurisdictions.
1) National
Initial efforts to educate and create partnerships at the national level include:
- HHS participation in national conferences and meetings,
- National Roundtable Discussions with key stakeholders, the media, and national organizations to discuss contributions and support for the Action Plan, and,
- Dedicated website housing key prevention information (pending resources), and
- The use of social networking sites, Web casts and blogs to disseminate information.
2) Regional
Educational stakeholder meetings plus additional training sessions for providers will be planned and hosted by HHS Regional Offices throughout the country and hosted by Regional Health Administrators.
The purpose of these initial meetings should be to communicate to providers and consumer organizations, and local healthcare providers to garner and advance support for reducing HAIs across the country and will:
- Share and promote the objectives of the Action Plan and campaign,
- Assess any concerns regarding implementation of the plan and campaign,
- Assess levels of acceptance,
- Assess any additional support providers would like to receive, and,
- Provide feedback on a media outreach campaign.
As the effort advances towards implementation, Regional Health Administrators should plan to provide training sessions targeted towards healthcare providers and administrators regarding the recommendations outlined and expressed in the Action Plan. These training sessions will augment any existing prevention activities already occurring at the local level, which were not generated by the Action Plan.
The training sessions will:
- Garner further support in advancing prevention, and
- Translate specific application of the guidelines into practical application.
VI. HHS Assets to Coordinate External Outreach
The following is a snapshot of existing HHS resources and assets that will be mobilized synergistically.
These agency-specific efforts should share information on the HHS Action Plan, share updated prevention information with key audiences, and help improve coordination among the many partners.
Various assets are available across the Department. A preliminary list of available resources for use in the near-term includes:
- Healthy People 2010 and Healthy People 2020 (in development).
Healthy People 2010 provides a framework for prevention for the Nation. It is a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats.
- Newsletters and Listservs
- Agency for Healthcare Research and Quality (AHRQ)
- Centers for Disease Control and Prevention (CDC)
- Clinician Outreach and Communication Activity (COCA) Listserv with Newsletter: www.bt.cdc.gov/coca
- CDC E-mail Blast to CDC Partners (newsletter): www.cdc.gov/Partners
- Rapid Notification System (RNS): www2.cdc.gov/ncidod/hip/rns/hip_rns_subscribe.html
- CDC E-cards: www2a.cdc.gov/eCards (Note: Personal e-cards can be sent to different audiences (consumers and healthcare providers) with a message about healthcare-associated infections.)
- Centers for Medicare and Medicaid Services (CMS)
- Provider Partnership Listserv: Representatives from 124 national provider associations sign up to this listserv after a face-to-face meeting with the Division Director for Division of Provider Information Planning and Development.
- All Medicare FFS provider types listserv (123,104 subscribers)
- Additional listservs that target the following groups/topics: Allied health, employers, quality, value based purchasing list (includes The Leapfrog Group and others), health plans, hospitals, cancer, consumer, disability, discharge planners, disease, long term care, pharmaceutical companies, physicians, and rural health lists.
- Websites
Websites that currently address issues related to or about healthcare-associated infections that will be utilized:
- Agency for Healthcare Research and Quality (AHRQ)
- Centers for Disease Control and Prevention (CDC)
- Centers for Medicare and Medicaid Services (CMS)
- Podcasts
- Agency for Healthcare Research and Quality (AHRQ)
- Radiocasts/podcasts via AHRQ's Healthcare411: http://healthcare411.ahrq.gov/
- Centers for Disease Control and Prevention (CDC)
- Website: www2a.cdc.gov/podcasts/player.asp?f=7953 (Can create a podcast and link to other HHS sources of info on HAIs)
- Meetings/Conference Calls/Conferences
- Centers for Disease Control and Prevention (CDC)
- Clinician Outreach and Communication Activity (COCA): www.bt.cdc.gov/coca (Conference calls that offer free CME to participants)
- Healthcare Infection Control Practices Advisory Committee (HICPAC): www.cdc.gov/ncidod/dhqp/hicpac.html (Liaisons representing American College of Occupational and Environmental Medicine, American Hospital Association, American Healthcare Association, Advisory Council for the Elimination of Tuberculosis, Association of Perioperative Registered Nurses, Association of Professionals of Infection Control and Epidemiology, Consumer’s Union, Council of State and Territorial Epidemiologists, Joint Commission, and Society for Healthcare Epidemiology of America)
- Media Listservs
HHS will utilize a Media listserv to email “news” updates to reporters, regionally and nationally, and will include usage of the following:
- AHRQ's Media /Reporters listserv
- CDC Division of Media Relations: www.cdc.gov/media/archives.htm (DMR has a broad listserv of reporters as well as list of reporters who cover CDC and some specific for HAIs)
- Office of Public Health and Science (OPHS)
- HHS Products
Operating Divisions, including AHRQ, CDC, and CMS, have already produced materials which should be added to the Website.
- AHRQ: Table containing AHRQ products
- CDC: Table containing CDC products
- CMS: Two different fact sheets listed under CMS Website
- HHS Products in Development
- Consumer brochure
- Posters for healthcare providers
- Buttons for healthcare providers
- Provider fact sheet
- “Top Ten Bill of Rights” laminated cards for consumers
- HHS Website on HAI, hosting information, linking to products, materials, conferences etc.
- CMS fact sheets which contain an overview description of Hospital Acquired Conditions and Present on Admission (currently being updated and should be available shortly)
VII. General Timelines for Projected Late Winter/Early Spring 2010 Launch
- Pre-Event Media Advisory/Press release: Issued in advance of the event
- Post-Event News Release: Issue news release summarizing the event after the event
- Media Roundtables: To continue the momentum across the country and engage the media, consumers and other stakeholders
- News Conference: To announce the launch of the media campaign
- On-site Media Room/Media Avail: Depending on details of the event, establish on-the-ground media support (media room or media availabilities)
- Radio and Television PSAs: To be released the day of campaign launch
VIII. Conclusion
The Department is committed to disseminating the Action Plan widely and will be working with its Regional Offices and many partners in broadcasting state of the art messaging that will help prevent and eliminate (to the greatest extent possible) healthcare-associated infections.
HHS will continue to focus its efforts on developing an effective strategy for building strong nationwide support for the plan to reduce the incidence of HAI. Utilizing a two tier, regional and national approach, the messages will be developed targeting both healthcare providers and consumer groups.
Messages will be disseminated via HHS resources including list servs, websites, and conference calls, as well as through the vehicles of communication provided through the partnership organizations.
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