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Raising Standards While Watching the Bottom Line Making a Business Case for Infection Control

Published online by Cambridge University Press:  31 March 2016

Eli N. Perencevich*
Veterans Affairs Maryland Health Care System, Baltimore, Maryland Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Patricia W. Stone
Columbia University School of Nursing, New York, New York
Sharon B. Wright
Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Yehuda Carmeli
Division of Infectious Diseases and Epidemiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
David N. Fisman
Child Health Evaluative Sciences Program, Research Institute of the Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Ontario Public Health Laboratories Branch, Toronto, Ontario, Canada
Sara E. Cosgrove
Division of Infectious Diseases and Antibiotic Management Program, Johns Hopkins Medical Institutions, Baltimore, Maryland
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Associate Hospital Epidemiologist, University of Maryland Medical Center, 100 N. Greene St., Lower Level, Baltimore, MD 21201 (


While society would benefit from a reduced incidence of nosocomial infections, there is currently no direct reimbursement to hospitals for the purpose of infection control, which forces healthcare institutions to make economic decisions about funding infection control activities. Demonstrating value to administrators is an increasingly important function of the hospital epidemiologist because healthcare executives are faced with many demands and shrinking budgets. Aware of the difficulties that face local infection control programs, the Society for Healthcare Epidemiology of America (SHEA) Board of Directors appointed a task force to draft this evidence-based guideline to assist hospital epidemiologists in justifying and expanding their programs. In Part 1, we describe the basic steps needed to complete a business-case analysis for an individual institution. A case study based on a representative infection control intervention is provided. In Part 2, we review important basic economic concepts and describe approaches that can be used to assess the financial impact of infection prevention, surveillance, and control interventions, as well as the attributable costs of specific healthcare-associated infections. Both parts of the guideline aim to provide the hospital epidemiologist, infection control professional, administrator, and researcher with the tools necessary to complete a thorough business-case analysis and to undertake an outcome study of a nosocomial infection or an infection control intervention.

SHEA Guideline
Copyright © The Society for Healthcare Epidemiology of America 2007

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