This series on outpatient services and infection control can seem rather dismal. Thankfully, most outpatient facilities are safe and only a small percentage of patients experience an HAI. Nonetheless, the breaches in infection control mean that given the right circumstances, severe outbreaks can (and do) take place. The reality can make us feel powerless and confused. Fortunately, there are things that we can do to help.
So far in our series on infection control in ambulatory care settings, we covered the types of facilities and how they are regulated. One huge topic to cover is the impact of the outpatient setting on the ability to track infections. Today’s post will begin to explore this topic, and our final post will present what we can do, both individually and collectively, to begin to improve infection prevention in these facilities.
We don’t know enough about infection in ambulatory care centers.
Any kind of medical treatment received outside of a hospital admission is considered ambulatory care, or outpatient care. This category of healthcare is growing very quickly; in fact, it is the fastest growing health care market in the US! Outpatient services are growing in popularity for two main reasons. First, they are less expensive than hospitals, which have much higher overhead costs. The second reason is that medical improvements have made outpatient services far more practical. The quality of home health care through technology and nursing services allow patients who would have had to be in a hospital receive the necessary care at home.
Up to 75% of surgical procedures in the US take place in the more than 5,000 outpatient surgical centers. (There was a 300% increase between 1996 and 2006, the last time a survey was made. More on that in our next post.) Add to this the number of scans, tests, dialysis sessions, chemotherapy treatments, and other procedures and you begin to see the vast numbers of individuals receiving medical care at ambulatory care facilities. As more and more of us choose these outpatient services for increasingly complex procedures, it is all the more important to learn about this critical area of health care.
In late January of 2016, the CDC issued a health advisory “urging dialysis providers and facilities to assess and improve infection control practices to stop Hepatitis C virus transmission in patients undergoing hemodialysis.” This advisory was released after an increase in Hepatitis C infections, and the preliminary evidence that transmission from patient to patient had taken place in at least 9 clinics. This advisory brought to mind the issue of infection in other outpatient settings and inspired the topic of our upcoming series, “Outpatient Services and Infection Prevention.”