BACK TO NURTURE Building an IPAC culture improves care, outcomes By Craig Yee
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t is well established in healthcare facility environments that infections related to construction, renovation or maintenance activities are a result of several breakdowns, such as lack of proper or clear policies and requirements, including sufficient control methods and measures; late or improper planning and design; late, improper, inadequate or no risk communications; and inadequate education, training and instruction. These represent symptoms of negative or fractured infection prevention and control (IPAC) cultures that exist and persist, even in today’s modern healthcare environments. If the objective is to protect occupants from infection risks, then these breakdowns cannot occur. Involved stakeholders must be on the same page to achieve IPAC success. A workplace culture is the character and personality of an organization, including shared attitudes, values, beliefs, perceptions, traditions, interactions and behaviours. With regard to IPAC, it is a healthcare facil-
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ity’s foundation upon which susceptible individuals are safeguarded from infections. Positive, collaborative and transparent healthcare facility cultures are critical to protect occupants from disease. At a high level, culture can significantly impact IPAC as demonstrated by many negative trends based on known evidence; indeed, infectious diseases resulting from various work tasks is not necessarily a result of random error or chance but caused by breakdowns in systems, processes, policies, communication and more. Positive cultures drive engagement and performance to achieve set goals and objectives. For stakeholders to really ‘buy into’ an IPAC culture, several elements need promoting. This includes senior leadership/ management commitments; implementing realistic, specific practices for addressing and mitigating infections; properly communicating across involved stakeholders (focusing on care and concern for occupant well-being); and committing to continuous organizational learning and improvement. An IPAC culture is not unlike worker
safety culture — infection control to population risk groups is essentially the same as safety to protect workers from hazards. The intents and principles are quite similar but the stakeholders and protection measures are slightly different. Like any workplace culture, it needs to be properly built and maintained for any modicum of success. If not, consequences can be quite significant, from unintended transmission of incurable diseases to occupant fatalities. Moreover, unaddressed risks can lead to other downstream problems, such as liability, culpability, reputational risks and even loss of public trust. One only needs to look at current infection events to understand the adverse outcomes when a broken, negative culture is allowed to persist. Committing to and focusing on a proactive, positive IPAC culture can prevent these consequences, over time. Organizations with positive commitments can better prioritize IPAC; anticipate risks, issues and problems; correct, rectify and control problems before harm is done; collaborate with various required stakeholders; and ‘own’
