2. Communication and Collaboration

Infection Control in Healthcare Personnel: Infrastructure and Routine Practices for Occupational Infection Prevention and Control Services (2019)

Background

Abbreviations
  • CMS = Centers for Medicare & Medicaid Services
  • HCO = Healthcare Organization
  • HCP = Healthcare Personnel
  • IPC = Infection Prevention and Control
  • OHS = Occupational Health Services
  • OSHA = Occupational Safety and Health Administration
  • PPE = Personal Protective Equipment
  • SESIP = Sharps with Engineered Sharps Injury Protection
  • TB = Tuberculosis

Effective internal communication and collaboration between OHS, other HCO departments, and HCP can enhance the safety of HCP and their patients.[1,2] OHS staff maintain effective communication pathways with a variety of departments, including:

  • IPC services
  • Clinical services
  • Engineering and facility management services
  • Environmental services
  • HCO leaders and managers
  • HCP representatives
  • Human resources
  • Information technology services
  • Laboratory services
  • Legal departments (e.g., risk management)
  • Pharmacies
  • Procurement and central supply services
  • Quality assurance and accreditation committees
  • Safety committees
  • Volunteer departments
  • Workers’ compensation

Explicit communication and collaboration between OHS and other HCO departments, particularly IPC services, can improve HCP safety and the delivery of occupational IPC services. Multidisciplinary committees can assemble diverse expertise to address cross-cutting issues such as assessing and selecting Sharps with Engineered Sharps Injury Protection (SESIP)[3]; developing tools to document HCP declination of immunization and to increase immunization rates[4]; and improving the capture and reporting of HCP immunization data (see section 6. Immunization Programs).[5]

Communication and collaboration among OHS and supervisors, senior management, human resources, IPC services, legal departments, and HCP are necessary to decrease the likelihood of HCP reporting to work when ill and to encourage adherence to recommended work restrictions, when indicated.[1] Box 2. Examples of Possible Areas of Collaboration lists areas related to occupational IPC in which communication and collaboration can be important.

Barriers to effective communication and collaboration can include:

  • dispersed staff and worksite locations (e.g., multi-hospital or healthcare setting network, contracted and off-site occupational health services), and
  • different requirements for staff not directly employed by a facility, such as credentialed private practice physicians and contractors.

Additional areas for communication and collaboration are discussed in section 1. Leadership and Management.

Recommendations

See section 1. Leadership and Management for additional related recommendations.

For healthcare organization leaders and administrators

Number

Recommendation

Number

2.a.

Recommendation

Establish organizational goals, policies and procedures, infrastructure, and interventions that foster communication and collaboration about occupational infection prevention and control.

For occupational health services leaders and staff

Number

Recommendation

Number

2.b.

Recommendation

Engage senior leaders, administrators, leaders of other programs that share activities related to occupational infection prevention and control, and healthcare personnel to foster collaborative decision-making.

Number

2.c.

Recommendation

Participate in the development of policies, procedures, and interventions that affect occupational infection prevention and control.

References

  1. Russi M, Buchta WG, Swift M, et al. Guidance for Occupational Health Services in Medical Centers. J Occup Environ Med. 2009 Nov;51(11):1e-18e.
  2. Recommended Practices for Safety and Health Programs: Communication and Coordination for Host Employers, Contractors, and Staffing Agenciesexternal icon. Occupational Safety and Health Administration. Accessed August 20, 2019.
  3. Hooper J, Charney W.Creation of a safety culture: reducing workplace injuries in a rural hospital setting. AAOHN J. 2005 Sep;53(9):394-8.
  4. Bertin M, Scarpelli M, Proctor AW, et al. Novel use of the intranet to document health care personnel participation in a mandatory influenza vaccination reporting program. Am J Infect Control. 2007 Feb;35(1):33-7.
  5. Melia M, O’Neill S, Calderon S, et al. Development of a flexible, computerized database to prioritize, record, and report influenza vaccination rates for healthcare personnel. Infect Control Hosp Epidemiol. 2009 Apr;30(4):361-9.

Box 2. Examples of Possible Areas of Collaboration for Occupational Infection Prevention and Control Services

Examples of performance measures that might be used to assess the effectiveness of occupational infection prevention services.
Possible Areas of Collaboration and Roles for Occupational Health Services Possible Internal Collaborators
Developing and disseminating policies and procedures about occupational IPC related to:
  • Risk assessment and reduction (e.g., tracking of trends in sharps injuries, participating in prevention efforts, selecting and evaluating PPE)
  • Respiratory protection programs
  • HCP immunization programs
  • Occupational infection prevention education and training
  • Medical evaluations
  • Infectious disease screening and surveillance (e.g., TB)
  • Management and reporting of exposures and illness among HCP
  • Work restrictions and clearance for returning to work
  • Sick leave
  • Infectious disease emergency planning/management (e.g., pandemic planning)
  • HCP records, information, and confidentiality
  • Central supply/equipment purchasing services
  • Clinical services
  • Communications/marketing services
  • Environmental services
  • Engineering and facility management services
  • HCP representatives
  • HCO leaders and managers
  • Human resources
  • IPC services
  • Laboratory services
  • Legal departments (e.g., risk management)
  • Pharmacy
  • Safety committee
  • Volunteer departments
  • Workers’ compensation
Participating in risk assessment and reduction activities for occupational IPC:
  • Collect, report, and interpret data (e.g., HCP immunization rates, exposure event information/trends, illness rates, lost work days due to exposures or illness)
  • Improve immunization programs
  • Enhance exposure prevention efforts
  • Participate in inspections and evaluations of potential hazards to HCP
  • Participate in surveillance and epidemiologic investigations that involve HCP
  • Clinical services
  • Construction services
  • Engineering and facility management services
  • Environmental services
  • Facilities management
  • HCP representatives
  • Human resources
  • Industrial hygiene
  • IPC services
  • Legal departments (e.g., risk management)
  • Procurement and central supply services
  • Safety committee
  • Volunteer departments
Assisting in accreditation and regulatory compliance activities pertaining to occupational IPC:
  • Track and ensure occupational IPC service compliance with regulations (e.g., federal, state and local), conditions of participation (e.g., CMS), and accreditation
  • HCP representatives
  • Human resources
  • IPC services
  • Legal departments (e.g., risk management)
  • Quality improvement
  • Regulatory compliance unit
  • Safety Committee
  • Volunteer departments
Supporting HCP occupational IPC education and training
  • Provide input on the curriculum, materials, and frequency of education and training for HCP
  • Participate in education and training
  • Environmental services
  • HCP representatives
  • Human resources
  • IPC services
  • Procurement and central supply services
  • Safety committee
  • Volunteer departments
Contributing to HCP immunization programs:
  • Propose strategies to optimize immunization coverage among HCP
  • Participate in collecting, interpreting, and reporting HCP immunization performance measures
  • HCO leaders and managers
  • HCP representatives
  • IPC services
  • Legal departments (e.g., risk management)
  • Quality improvement
  • Regulatory compliance unit
  • Safety committee
  • Volunteer departments
Developing policies and procedures for HCP exposures and illness management:
  • Enable prompt access to OHS for exposure and illness management
  • Notify relevant departments and individuals about:
  • HCP exposures or illnesses, work restrictions, and clearance for return to work
  • Notification of contacts of infected or ill HCP
  • Results of exposure investigations (e.g., products or circumstances associated with exposures or illnesses)
  • Clinical Services
  • HCP representatives
  • Human resources
  • IPC services
  • Laboratory services
  • Regulatory compliance (OSHA standards)
  • Safety committee
  • Volunteer departments
  • Workers’ compensation
Contributing to product evaluation related to occupational IPC:
  • Provide input on PPE and patient care equipment (e.g., SESIP)
  • Clinical services
  • Environmental services
  • Engineering and facility management services
  • HCP representatives
  • IPC services
  • Procurement and central supply services
  • Safety committee
  • Volunteer departments
Implementing methods for managing HCP health records:
  • Ensure confidentiality of medical information while maintaining ready access for urgent medical evaluations such as exposure or illness management
  • Utilize a confidential notification processes, such as for reporting HCP illnesses within the HCO or externally to public health departments
  • HCP representatives
  • Human resources
  • Information technology services
  • Legal departments (e.g., risk management)
  • Regulatory compliance unit
  • Safety committee
  • Volunteer departments
  • Workers’ compensation
Collaborating in managing outbreaks involving HCP:
  • Report possible outbreaks detected among HCP to appropriate internal departments or individuals and external agencies (e.g., public health)
  • Assist with determining the nature of an HCP exposure and who else was potentially exposed
  • Monitor HCP for development of disease
  • Test HCP for infection
  • Evaluate, treat, and counsel exposed or ill HCP as appropriate
  • Clinical services
  • HCP representatives
  • IPC services
  • Laboratory services
  • Legal departments (e.g., risk management)
  • Safety committee
  • Communications/marketing services
  • Volunteer departments
Participating in planning for emergencies involving infectious diseases:
  • Evaluate event-specific policies, procedures, infrastructure, and interventions for occupational IPC services
  • Conduct site inspections and hazard evaluations
  • Develop event-specific occupational infection prevention and control education and training for HCP
  • Clinical services
  • Communications/marketing services
  • Emergency response coordinator
  • Engineering and facility management services
  • Environmental services
  • HCO leaders and managers
  • HCP representatives
  • Human resources
  • IPC services
  • Laboratory services
  • Legal departments (e.g., risk management)
  • Procurement and central supply services
  • Safety committee
  • Volunteer departments