Infection prevention is complicated enough, but in resource-limited settings it can pose an even greater challenge. On March 29, 2017, at the Society for Healthcare Epidemiology of America (SHEA) Spring 2017 Conference in St. Louis, Missouri, Rebekah Moehring, MD, MPH, assistant professor, Duke Infection Control Outreach Network (DICON), Duke University Medical Center, shared strategies for building internal capacity to work together to tackle common goals through a collaborative effort between the quality, antimicrobial stewardship, and infection prevention departments.
“I think that when we think about these three different programs in our hospitals, often we think of them as separate entities, but in the resource-limited setting there is actually much more overlap and the reason is that there’s just a limited number of personnel to perform these roles,” Dr. Moehring states. “So, being able to overlap in terms of our efforts, really serves all three programs very well, if we can come together and have a similar initiatives and goals to go after together. How can we do this?”
First, Dr. Moehring discussed the concept of the “small n” in resource-limited settings, which referred to the fact that there is a smaller number of staff to perform tasks that need to get done and adequately implement initiatives. Where in some instances this can be a drawback, in other instances this can also work in the favor of the facility. With less staff, developing personal relationships with colleagues is easier, and these relationships “are the key to success.” Dr. Moehring added, “I think in resource-limited settings it’s especially important because it’s the same people you’re working with for more than one task that needs to get done.”
When it comes to building internal capacity to meet these goals, first find common ground among personnel working in all three departments (quality, infection prevention, and antimicrobial stewardship). Where do they overlap? According to Dr. Moehring, all of these programs strive for: providing safe and effective care, improving patient experience, improving the reputation of the institution, working towards improving the utilization of resources, and meeting regulatory needs “that keep [the] doors open and keep [the] service to patients going,” she said.
Dr. Moehring continued to provide tips on “the best way to deliver a message,” to accomplish goals across departments. The best way to do this is to be specific when appealing for help. “I think just recognizing that you’re coming from different perspectives, understanding that it’s a shared problem that we all work on, and then giving something very specific [that we need] to attack together” is important, according to Dr. Moehring. To do this, you need to “play to their strengths” and “speak their language.”