“An avoided infection does not really affect the bottom line.” Are you sure?

I spent more than twenty years as a Corporate Director of Infection Prevention for an Integrated Health Care Delivery Network (IDN). During that time, I learned a great deal about managing infection prevention and about corporate leadership culture and priorities. My job was to secure senior leadership support for the major initiatives my team wanted to execute to reduce infection risk. Over the years, communicating the financial impact of our proposals became more fundamental to securing approval due to the increasing financial and operational challenges our organization faced.

I learned two important things: First, hospital leadership often does not understand the actual cost of an avoided infection, an HAI (healthcare associated infection). Many think it is a “sunk” or “soft” cost and fail to realize the true operational and financial impact of reducing infections. Second, while protecting patients is a priority, if a care improvement proposal does not make economic and operational sense, it will not get approved.

These two lessons taken together result in undervaluing an infection that does not happen. In addition, accounting cannot directly reflect the cost of an infection that does not happen, and Supply Chain is responsible for the cost of the infection but is not credited with the benefit of an avoided infection. As a result, healthcare organizations often miss opportunities to better protect patients and improve quality that are advantageous for the bottom line and organizational reputation.

Let’s look at one of my favorite examples, central line associated blood stream infections (CLABSI). A CLABSI is typically not reimbursed by CMS and costs an additional ~ $48,000 to treat and increases length of stay (LOS) by ~7.5 days. The math is simple, your expense line goes up by $48,000 and your revenue line goes up by $0. Your bottom line just got worse by $48,000.

When you prevent a CLABSI, you free up a bed more quickly. If you put an average CMS patient in that bed you would generate ~ $50,000 in revenue and incur $21,000 in additional treatment cost. Your expense line goes up by $21,000 and your revenue goes up $50,000—your bottom line just went up by $29,000.

The difference between these two scenarios, losing $48,000 and gaining $29,000 in revenue, is the actual impact of the avoided CLABSI on your bottom line—$77,000.

HAIs not only increase treatment costs and LOS but can also trigger CMS penalties that can easily run into hundreds of thousands of dollars and can impact your Leapfrog and other scores which could harm your organization’s reputation.

Can an HAI reduction program generate enough avoided infections to make an impact? The chart below shows the infection reduction(s) and resulting cost impacts comparing the 2 years pre-implementation and 2 years post- implementation of a nasal decolonization program at a 320 bed hospital.

Reported Impact of Nasal Decolonization Program at a 320 Bed Hospital

This is the kind of information leadership needs to evaluate this opportunity vs the many other competing options.

Increasingly, your industry partners can help you estimate the impact on infections, operations, and finance to build a solid value proposition. They can also aid in implementation planning, execution and compliance management. You can easily find out if a nasal decolonization program like the one above makes sense for you. What other option can deliver this kind of return on investment (ROI) with no capital expense, no additional labor, no software to buy or implement, and where you can easily adjust the program if you fail to see the anticipated benefits?

Infection Prevention can compete with any other investment opportunity- if you take the time to prepare your value proposition and present it clearly and effectively. It is information your leadership needs to make optimal resource allocation decisions. Protecting patients from devastating infections and saving lives is our responsibility – and it is good for business.

Connie Steed, MSN, RN, CIC, FAPIC, has worked in the field of infection prevention and control for over 40 years. She most recently served as the Corporate Director of Infection Prevention at Prisma Health in South Carolina, from which she retired. Connie is currently a consultant specializing in infection prevention and control. Connie is a Fellow of the Association of Professionals in Infection Control and Epidemiology (APIC). She has served as 2020 APIC President and was the recipient of the 2018 APIC President’s Distinguished Service Award in Honor of Patricia Lynch and the Carol DeMille Achievement Award in 2024. Connie is currently serving on the Centers for Disease Control and Prevention (CDC) HICPAC committee and the NHSN, Personnel Health and Isolation Precautions Work Groups. She is published in the field and has presented nationally and internationally.