Translating and Scaling the HHS Action Plan to Prevent Healthcare-associated Infections to the Local Level Experience of a Los Angeles Health System

Background: The US Department of Health and Human Services National Action Plan to Prevent Healthcare-associated Infections (HAIs) set 5-year national-level goals beginning in 2009 for reducing the most common and serious HAIs. Meeting these goals on the local level depended on generalizing and sustaining evidence-based infection prevention practices at the >5000 US community and federal acute care hospitals. Objectives: To describe the impact of the Federal and California State HAI Action Plans on UCLA Heath, an academic health system in Los Angeles, in planning and implementing HAI prevention activities and reducing HAI rates. Methods: The Context-Input-Process-Product model and the systems functions and properties framework were applied to the evaluation of infection prevention and control activities at UCLA Health. Results: Resource constraints, competing priorities, variation in care practices, provider engagement, and the expanding administrative burden of public reporting were some of the challenges to implementing and sustaining HAI prevention practices at the local level. Progress toward reducing targeted HAI rates in UCLA Health has paralleled the results observed on the state and national level, including declining infections associated with medical devices, surgical procedures, and multidrug-resistant organisms. Conclusions: In California, federal funding supporting the state HAI Action Plans and mandatory public reporting requirements spurred adoption, implementation, and evaluation of HAI prevention efforts and helped to drive collaborative performance improvement and research at the facility level.