Latest / The SHEA Podcast / The SHEA Podcast | Existing Public Health Infrastructure for HAI/AR

Transcript

The SHEA Podcast | Existing Public Health Infrastructure for HAI/AR · The SHEA Podcast

• 0:06
  SPEAKER_03: Welcome to Shay's Podcast.
• 0:08
  SPEAKER_03: I'm Dr.
• 0:08
  SPEAKER_03: Jorge Salinas.
• 0:10
  SPEAKER_03: I'm the Medical Director of Infection Prevention and Control at Stanford Healthcare.
• 0:15
  SPEAKER_03: I'm also co-chair of Shay's Public Health Task Force.
• 0:18
  SPEAKER_03: I'm very pleased to serve as today's moderator as we discuss how existing public health infrastructure can address healthcare-associated infections and antimicrobial resistance.
• 0:30
  SPEAKER_03: Before we get started, I'd like to introduce you to today's speakers.
• 0:33
  SPEAKER_03: Dr.
• 0:34
  SPEAKER_03: Joseph Peirce serves as Deputy Branch Chief and Senior Advisor for Public Health Programs in the Prevention and Response Branch within CDC's division of healthcare quality promotion, based in Atlanta.
• 0:46
  SPEAKER_03: During his nearly 25-year tenure with the CDC, Joe has guided dozens of outbreak investigations and special studies, drawing attention to the need for injection safety and other basic infection control practices.
• 1:01
  SPEAKER_03: His activities currently involve interagency collaboration, support to health departments, and other partnership efforts aimed at expanding prevention and response activities across all healthcare settings.
• 1:15
  SPEAKER_03: Next, we have Melissa Cumming joining us.
• 1:18
  SPEAKER_03: Melissa is a senior epidemiologist and a healthcare associated infections and antimicrobial resistance program manager at the Massachusetts Department of Public Health.
• 1:28
  SPEAKER_03: Overseeing related surveillance, prevention, and response activities across the healthcare continuum.
• 1:34
  SPEAKER_03: Her program is also responsible for oversight of the department's antimicrobial stewardship and chemovigilance initiatives.
• 1:41
  SPEAKER_03: Melissa has more than 24 years of applied epidemiology experience with the department, including leading numerous outbreak investigations and authoring or co-authoring many peer-reviewed publications.
• 1:53
  SPEAKER_03: She's also board certified in infection prevention and control.
• 1:56
  SPEAKER_03: Welcome to the podcast, Joe and Melissa.
• 1:58
  SPEAKER_03: I'm excited to hear your opinion today.
• 2:01
  SPEAKER_03: Thank you.
• 2:02
  SPEAKER_01: Thank you.
• 2:03
  SPEAKER_03: For listeners who are new to the field, what is public health role in healthcare specific to communicable diseases?
• 2:11
  SPEAKER_03: Joe, why don't you start with a big picture view?
• 2:15
  SPEAKER_04: Sure.
• 2:15
  SPEAKER_04: I would say broadly speaking, government agencies have myriad roles and functions in support of safe healthcare delivery.
• 2:24
  SPEAKER_04: Part of this relates to infectious disease surveillance, prevention and response.
• 2:29
  SPEAKER_04: At the federal level, we have regulatory agencies such as FDA and OSHA.
• 2:35
  SPEAKER_04: There is CMS, which is both a major payer and regulator.
• 2:40
  SPEAKER_04: Not to mention DOT, Department of Transportation, EPA, Environmental Protection Agency, and so on.
• 2:48
  SPEAKER_04: So there's a lot to unpack there, but listeners who work in healthcare settings will be generally familiar with health and safety standards that have their roots in federal regulations, right?
• 2:59
  SPEAKER_04: Like the OSHA Bloodborne Pathogen Standard, for example.
• 3:02
  SPEAKER_04: There are also non-regulatory agencies like AHRQ, whose mission relates clearly to healthcare quality and research.
• 3:12
  SPEAKER_04: Now, we don't always think of all these federal entities as public health agencies, but they do certainly shape the patient safety and worker safety landscapes, and they set the stage for more traditional public health actors.
• 3:26
  SPEAKER_04: So that brings me to CDC, my agency, which is the primary federal public health agency.
• 3:35
  SPEAKER_04: And while CDC holds limited regulatory powers, it does have great influence over healthcare safety and quality, particularly as relates to communicable disease control.
• 3:46
  SPEAKER_04: And so for example, CDC directs or supports many activities related to developing guidance and measuring, preventing, investigating the occurrence of healthcare-associated infections.
• 4:00
  SPEAKER_04: And that includes AR pathogens, right?
• 4:03
  SPEAKER_04: Antimicrobial resistant pathogens.
• 4:06
  SPEAKER_04: So a lot of CDC's work actually relates to state public health uh agencies, and I should probably pause there.
• 4:16
  SPEAKER_03: Thanks, Joe.
• 4:17
  SPEAKER_03: Melissa, would you mind picking it up here?
• 4:20
  SPEAKER_01: Sure.
• 4:20
  SPEAKER_01: So from the State Health Department perspective, at a very high level, our HAI AR program's role is essentially to conduct surveillance, prevention, and response activities specifically related to healthcare-associated infections, including those caused by AR pathogens, which unfortunately, as we all know, are increasing pretty dramatically among those who receive health care.
• 4:49
  SPEAKER_01: So, in a nutshell, this entails monitoring surveillance data as well as investigating cases and clusters, but also, and I think very importantly, supporting healthcare facilities in their efforts to prevent and respond to these events.
• 5:06
  SPEAKER_01: We additionally play a fairly significant role in promoting infection prevention and control and antimicrobial stewardship best practices across the healthcare continuum, and in particular, skilled nursing facilities and dialysis facilities in a really targeted effort to prevent HAI and AR.
• 5:28
  SPEAKER_01: And we do this in large part by conducting both preventive and responsive infection control assessment response or ICAR visits in healthcare facilities on a regular basis.
• 5:39
  SPEAKER_01: And all of this work at the state health department level is really supported and guided by funding that's provided through several CDC funding streams.
• 5:51
  SPEAKER_03: Joe, Melissa mentioned that state HAI programs receive support from CDC.
• 5:56
  SPEAKER_03: What does that look like?
• 5:58
  SPEAKER_03: Yeah, sure.
• 5:59
  SPEAKER_04: So health departments receive financial and technical support from CDC through multiple avenues.
• 6:06
  SPEAKER_04: One that's very important for this conversation is a cooperative agreement known as ELC for epidemiology and laboratory capacity.
• 6:16
  SPEAKER_04: Specific support through this mechanism for HAI programs dates back to 2009.
• 6:23
  SPEAKER_04: And that support has grown considerably over the years as the value of HAI programs has been increasingly recognized, most recently during the COVID pandemic.
• 6:37
  SPEAKER_03: Thank you.
• 6:38
  SPEAKER_03: Melissa, how does your work intersect with state regulatory agencies?
• 6:43
  SPEAKER_01: Oh, that's a really great question.
• 6:45
  SPEAKER_01: While our program works very closely with our state healthcare quality and safety regulatory partners, both within the Department of Public Health and outside of the department, our program actually does not have a regulatory function.
• 7:00
  SPEAKER_01: And so this allows us to work collaboratively with hospital or other healthcare facility partners to provide sort of an initial buffer or safe space where regulatory entities are not involved.
• 7:14
  SPEAKER_01: But we can provide situational awareness and subject matter expertise.
• 7:19
  SPEAKER_01: Essentially, our collective goal is to prevent HAI and AMR.
• 7:23
  SPEAKER_01: And that often means working very closely with our healthcare partners by sharing lessons learned and providing situational awareness about what we are seeing across the state.
• 7:33
  SPEAKER_01: And from the health department's perspective, we have the advantage of sort of seeing the bird's eye view of what's happening across all of the healthcare facilities in our jurisdiction, which is often very helpful to an individual facility experiencing an outbreak or a cluster.
• 7:53
  SPEAKER_02: Joe, would you like to add to that?
• 7:56
  SPEAKER_04: Sure.
• 7:57
  SPEAKER_04: I think Melissa made some great points there.
• 7:59
  SPEAKER_04: HAI programs are not primarily regulatory, but they do have authority to investigate potential public health threats, including when those occur in healthcare settings.
• 8:11
  SPEAKER_04: And this starts with outbreak reporting requirements that are present in virtually every state.
• 8:17
  SPEAKER_04: Also, as Melissa noted, there are points of intersection with regulatory agencies.
• 8:23
  SPEAKER_04: And one example of that would be how many HAI or AR investigations are themselves a path to identifying concerns for medical product contamination.
• 8:37
  SPEAKER_04: So in that instance, we will work very closely with entities such as the Food and Drug Administration or FDA.
• 8:48
  SPEAKER_04: And as you know, listeners are aware, sometimes these medical product contamination events are national, even international in scope.
• 8:57
  SPEAKER_04: A recent example would be the extensively drug-resistant Pseudomonas erugenosa outbreak, right?
• 9:03
  SPEAKER_04: The one that was associated with artificial tears.
• 9:06
  SPEAKER_04: That was an over-the-counter product that was manufactured overseas and used in healthcare settings, but also marketed directly to consumers.
• 9:14
  SPEAKER_04: And I would say that our collective efforts, you know, across the healthcare partners and the public health partners, you know, were really essential to identifying that public health threat and resulting in strong regulatory action.
• 9:34
  SPEAKER_03: Lisa, back to you.
• 9:35
  SPEAKER_03: Can you describe how your work intersects with other state partners, such as healthcare systems, professional associations, or quality improvement organizations?
• 9:45
  SPEAKER_01: Oh, sure.
• 9:46
  SPEAKER_01: So we we really work hard to maintain regular and collaborative communication networks and open channels with these partners.
• 9:58
  SPEAKER_01: We participate in a variety of standing monthly meetings to share ongoing activities and initiatives, um, you know, to avoid duplication and to foster collaboration, of course.
• 10:09
  SPEAKER_01: And we do work regularly work with these entities on HAI and AR prevention initiatives, including educational offerings, uh, situational awareness updates, and also importantly, leveraging resources from both sides.
• 10:26
  SPEAKER_03: Thank you.
• 10:27
  SPEAKER_03: Wow, sounds like you have your hand full.
• 10:30
  SPEAKER_03: How do you manage all the partner interactions?
• 10:32
  SPEAKER_03: Do you have any structures in place?
• 10:35
  SPEAKER_01: Oh, yes, we certainly do.
• 10:37
  SPEAKER_01: Since 2009, actually, there has been a CDC requirement of the ELC funding agreement that all state HAI AR programs maintain a statewide HAI AR technical advisory group, or TAG.
• 10:54
  SPEAKER_01: And these groups meet regularly.
• 10:57
  SPEAKER_01: And in our state, we meet at least quarterly, and the members of these groups provide input and guidance on HAI and AR-related issues, questions, and they bring often bring concerns to the TAG.
• 11:12
  SPEAKER_01: Participants of our statewide TAG in Massachusetts include multiple different healthcare facility types, so representatives from all of those settings, also including representatives from professional organizations, uh, patient safety collaboratives, and both regulatory and non-regulatory state health partners.
• 11:33
  SPEAKER_01: And this infrastructure really helps to support our efforts to manage so many partner interactions, and it definitely provides us much needed insight and perspective.
• 11:44
  SPEAKER_01: And I will I have to say, a great example of the utility of our tag was really seen during the COVID pandemic.
• 11:53
  SPEAKER_01: We had requests from our tag to meet constantly, to discuss changes to guidance, suggestions to guidance, um, response to new guidance, and things of that nature.
• 12:06
  SPEAKER_01: So it really served a critical need, at least in Massachusetts, over the course of the COVID pandemic.
• 12:13
  SPEAKER_03: Thank you.
• 12:14
  SPEAKER_03: Joe, can you talk more about uh quality improvement networks and organizations?
• 12:19
  SPEAKER_03: Are those funded by CMS?
• 12:20
  SPEAKER_03: Is that correct?
• 12:22
  SPEAKER_04: Yes.
• 12:23
  SPEAKER_04: CMS funds the Quinn QIOs, or QIOs for short, quality improvement organizations, to work with facilities, mostly hospitals and nursing homes.
• 12:33
  SPEAKER_04: And this is done under contract from CMS.
• 12:37
  SPEAKER_04: They work with those facilities on a voluntary basis to improve quality and outcomes.
• 12:42
  SPEAKER_04: This is sort of complementary to another CMS funding stream, which is more regulatory in nature, right?
• 12:48
  SPEAKER_04: So CMS also funds what we refer to as state survey agencies.
• 12:53
  SPEAKER_04: Those are the entities that are um in charge of healthcare facility licensing and compliance.
• 12:59
  SPEAKER_04: So it's kind of a carrot and stick approach, you know, that CMS is deploying here.
• 13:03
  SPEAKER_04: The QIOs, I would say, have a very broad scope of work.
• 13:07
  SPEAKER_04: It does intersect with HAI prevention.
• 13:11
  SPEAKER_04: And as an example, the QIOs were very active in assisting with COVID-19 vaccination efforts in nursing home settings.
• 13:19
  SPEAKER_04: And many of the QIOs are part of the tags or uh advisory groups that Melissa referenced and work with HAI programs on IPC education.
• 13:30
  SPEAKER_03: Thank you.
• 13:31
  SPEAKER_03: Uh Melissa, a lot of your response work relates to antimicrobial resistance.
• 13:36
  SPEAKER_03: Can you talk about that, please?
• 13:38
  SPEAKER_01: Yes, of course.
• 13:39
  SPEAKER_01: So as a program, we conduct surveillance for and respond to the detection of high-priority AR pathogens such as carbopenemase producing organisms and candidate oris.
• 13:53
  SPEAKER_01: In Massachusetts, our state public health laboratory, which is part of the National AR Lab Network, conducts PCR testing for carbopenemase-producing gene targets for submitted CRE, CRPA, and crab isolates.
• 14:09
  SPEAKER_01: And they also conduct whole genome sequencing of every CPO that is identified.
• 14:16
  SPEAKER_01: And so this really enhances our ability to uncover transmission pathways that really are not readily apparent through epidemiologic investigation alone.
• 14:25
  SPEAKER_01: And so that's very important to our work and really enhances it.
• 14:30
  SPEAKER_01: We also work very closely with our regional AR Lab Network partner, the Wadsworth Laboratory in Albany, New York, to facilitate both proactive and responsive colonization screening of exposed individuals in Massachusetts healthcare facilities for both CPOs and candidate auras.
• 14:49
  SPEAKER_01: And so that's also a really important tool in our toolbox when trying to both prevent and contain these NDRO outbreaks.
• 14:59
  SPEAKER_01: Additionally, and this may be of particular relevance to clinicians, the AR lab network also offers expanded antimicrobial susceptibility testing for the treatment of serious infections caused by metallobitalactamase producing enterobacterali.
• 15:19
  SPEAKER_01: So specifically for the combination therapy, septazideme, avibactum plus S trianem, which is a treatment option available in current IDSA guidance for such infections.
• 15:30
  SPEAKER_01: But the capability to do that type of expanded AST is typically not available in most clinical laboratories.
• 15:39
  SPEAKER_01: And I think it's also really important to point out that all services provided through the National Air Lab Network, including at our Mass State Public Health Laboratory, are at no cost to healthcare facilities or patients.
• 15:52
  SPEAKER_03: That's great to hear.
• 15:54
  SPEAKER_03: Also, these antimicrobial resistance surveillance and response capabilities seem to be increasing and are very impressive.
• 16:02
  SPEAKER_03: But also, this got me thinking about antimicrobial stewardship as a means of preventing and slowing antimicrobial resistance.
• 16:10
  SPEAKER_03: Do the HAI and antimicrobial resistance programs work well at that level too?
• 16:17
  SPEAKER_03: Yes, we certainly do.
• 16:19
  SPEAKER_01: Like other HAIAR programs and health departments across the country, we have an antimicrobial stewardship lead on our team whose sole focus is promoting appropriate use of antimicrobials really across the healthcare continuum.
• 16:35
  SPEAKER_01: And this work takes many forms from engaging long-term care facilities to evaluate their antimicrobial prescribing practices to leveraging NHSN AUR data reported by acute care hospitals.
• 16:49
  SPEAKER_01: That's antimicrobial use and resistance data.
• 16:53
  SPEAKER_01: We're also partnering with ambulatory care organizations locally to evaluate clinical decision support tools to improve antimicrobial prescribing.
• 17:02
  SPEAKER_01: And that's just to name a few of our antimicrobial stewardship efforts.
• 17:09
  SPEAKER_03: Wow, great.
• 17:10
  SPEAKER_03: Anything else in the mix of activities that you think our listeners should know about?
• 17:15
  SPEAKER_04: Yeah, let me jump in.
• 17:17
  SPEAKER_04: I would say, you know, when I think back when the programs were first established, there was a lot of emphasis on assisting hospitals in particular with getting enrolled in the National Healthcare Safety Network or NHSN to begin conducting surveillance so that we could better monitor HEI data and use that to focus prevention efforts.
• 17:40
  SPEAKER_04: And hopefully many listeners are familiar with the TAP strategy, right?
• 17:45
  SPEAKER_04: Which is about targeting, assessing, and preventing.
• 17:49
  SPEAKER_04: And thinking back on that, looking back at that, I think you know, we we take a lot of satisfaction with the role that the HEI programs played in helping facilities reduce uh CLABsy rates and rates of other hospital uh associated infections.
• 18:05
  SPEAKER_04: And we've really seen those rates go down tremendously and you know the work continues, it evolves.
• 18:11
  SPEAKER_04: But um, you know, I think we should uh reflect on that and be happy for the gains made in that area.
• 18:18
  SPEAKER_01: And speaking of NHSN, I think it's also worth noting that as of this year in 2024, all acute care facilities are required by CMS to be working toward the capability of reporting NHSN AUR module data.
• 18:36
  SPEAKER_01: So all antimicrobial use and antimicrobial resistance data to NHSN.
• 18:42
  SPEAKER_01: And this is a really important time, I think, for state HAI AR programs to engage with their acute care facilities to really try to support them with this new reporting requirement.
• 18:53
  SPEAKER_01: And also, you know, HAI AR programs will then have an opportunity to then leverage this data statewide for you know meaningful use.
• 19:03
  SPEAKER_01: And, you know, as an example, in Massachusetts, our tag has an AU subcommittee.
• 19:10
  SPEAKER_01: And the members of that AU subcommittee are now holding special calls for facilities to reach out and receive support from others who are further along in this process.
• 19:21
  SPEAKER_01: And we think that's something very beneficial that we're able to facilitate and offer to our acute care facilities.
• 19:29
  SPEAKER_01: That's great.
• 19:30
  SPEAKER_04: Anything else?
• 19:32
  SPEAKER_04: Yeah, actually, there is something else I would like to mention, which is one of the our newer activities introduced um early in the pandemic, and that involves Project First Line.
• 19:41
  SPEAKER_04: So CDC organized Project First Line as a collaborative involving healthcare, academic, and public health partners, including the HAI AR programs.
• 19:52
  SPEAKER_04: And the idea here was to equip frontline healthcare workers with infection control knowledge, tools, and resources that explain not just what to do, but the rationale behind the science.
• 20:05
  SPEAKER_04: And I think it Project First Line is rather unique in that it it focuses on groups like technicians, allied health professionals, environmental service workers, you know, groups that have often been overlooked.
• 20:20
  SPEAKER_03: Let's pivot a bit here to discuss ways that our listeners, especially those like me that are hospital-based, uh and uh how can we partner effectively?
• 20:31
  SPEAKER_03: How can we uh utilize these resources that you have described?
• 20:36
  SPEAKER_04: Yeah, I think, you know, at a high level, right?
• 20:39
  SPEAKER_04: Um, this hospital facility partnership with the HAI AR programs is something that we think is vitally important.
• 20:47
  SPEAKER_04: And I think that that's true, you know, whether you're an academic medical center or a community hospital.
• 20:52
  SPEAKER_04: I'd say the goal is to establish strong relationships built on a foundation of mutual understanding and regular dialogue.
• 21:02
  SPEAKER_01: Yeah, I couldn't agree more, Jo.
• 21:04
  SPEAKER_01: Um I really think that collaboration and leveraging each other's strengths, expertise, and capacity typically results in faster resolution of problems, such as outbreaks or higher rates of HAIs.
• 21:18
  SPEAKER_01: For example, our state public health laboratory recently identified through whole genome sequencing a number of isolates of a particular CPO that were highly related.
• 21:27
  SPEAKER_01: And when EPI investigation revealed that all had been patients on a common unit in an acute care facility, we were able to share that information immediately with the facility.
• 21:38
  SPEAKER_01: And so that, along with an ICAR visit from our HAI AR program staff, really helped the facility to very quickly identify measures to prevent additional transmission on this unit.
• 21:51
  SPEAKER_01: And this all happened really rather quickly.
• 21:54
  SPEAKER_01: And it was truly part of a collaborative effort between the state public health laboratory.
• 22:00
  SPEAKER_01: The HEIAR program and the acute care facility, who was incredibly receptive, you know, to receive this information and to have us come on site in a collaborative, non-regulatory circumstance.
• 22:14
  SPEAKER_01: And I think the outcome was, you know, good in this case.
• 22:18
  SPEAKER_01: And just to just to reiterate, and I I've said it before, I think, but I think it's important to highlight, whenever our HAIAR program members conduct an on-site ICAR, it truly is a collaborative process.
• 22:30
  SPEAKER_01: We learn as much during these visits as I think facility staff learn.
• 22:35
  SPEAKER_01: And it really enables us to share best practices, new ideas and lessons learned with other facilities, you know, that we will go into subsequently.
• 22:45
  SPEAKER_01: So I really think it's a win-win for all involved.
• 22:49
  SPEAKER_03: Thank you for sharing these great uh examples of partnership.
• 22:54
  SPEAKER_03: And I'm also glad that Shay has the public health task force and also a community healthcare epidemiologist and stewards special interest group.
• 23:03
  SPEAKER_03: Uh, but I'm uh also wondering if there are other national associations that are partnering at the state or federal level with hospitals.
• 23:14
  SPEAKER_03: Uh, how do they factor in?
• 23:16
  SPEAKER_03: Yeah, I'll start.
• 23:17
  SPEAKER_04: Uh on the public health side, four organizations I think deserve to be highlighted for helping advance this work.
• 23:24
  SPEAKER_04: And um, I'll begin with CSTE, which is the Council of State and Territorial Epidemiologists.
• 23:30
  SPEAKER_04: CSTE, you know, for years now has uh supported a uh a community, an HAI subcommittee.
• 23:39
  SPEAKER_04: And it's uh great to see how that's grown.
• 23:41
  SPEAKER_04: Though the monthly calls uh now regularly have over 400 members joining.
• 23:47
  SPEAKER_04: So that's really been great.
• 23:49
  SPEAKER_04: ASTO is another one, that's the Association of State and Territorial Health Officials.
• 23:53
  SPEAKER_04: It's like your health commissioners, it's that level.
• 23:56
  SPEAKER_04: Um, and then we have NATO, which is sort of the other end of the spectrum.
• 24:00
  SPEAKER_04: It's NATO stands for National Association of County and City Health Officials.
• 24:04
  SPEAKER_04: They're closely involved in uh supporting all this work as well.
• 24:08
  SPEAKER_04: And then the fourth one to sort of round out those professional uh public health uh groups is APHL, which is the Association of Public Health Laboratories.
• 24:19
  SPEAKER_04: And I guess uh, you know, reflecting on this, right?
• 24:22
  SPEAKER_04: We, you know, of course we have Shay and Melissa and I are very you know proud and pleased to be part of the public health task force.
• 24:28
  SPEAKER_04: You know, I think we should also acknowledge contributions from groups like APIC, and yeah, a lot of good work is going on, you know, to bring, I'd say, healthcare and public health together to make uh outbreak detection and investigation and HAI prevention, you know, more consistent, more effective.
• 24:45
  SPEAKER_04: Melissa, would you like to tag on?
• 24:47
  SPEAKER_01: Sure.
• 24:48
  SPEAKER_01: There is one additional collaboration that's very near and dear to my heart that I would like to give a plug for.
• 24:54
  SPEAKER_01: Um, as I think we're all pretty acutely aware, recent uh infectious disease-related public health challenges really have demonstrated the need for long-term ID clinician partners to support our local, state, and national public health agencies.
• 25:12
  SPEAKER_01: And ID clinicians, we know, have frequently ended up on the front line of medical communication regarding public health topics.
• 25:21
  SPEAKER_01: But most recently, such as home isolation, um, vaccination, disease treatment, and they typically are the ones spearheading critical studies that help to create and refine our public health response to these crises.
• 25:35
  SPEAKER_01: But despite this critical role that these providers find themselves in, there really are very few medical training pathways directly aimed at developing ID clinicians with the interest and experience necessary to work hand in hand with public health departments.
• 25:53
  SPEAKER_01: But there is one such program known by the leaders in epidemiology, antimicrobial stewardship, and public health, or many of you may know it as LEAP Fellowship Program.
• 26:04
  SPEAKER_01: This is an intensive one-year training program that's really aimed at providing these early career infectious disease physicians with the experiences and support that they need really to develop careers working with public health.
• 26:20
  SPEAKER_01: This program was started, I believe, in 2018 as a pilot initiative of the three major US ID societies.
• 26:28
  SPEAKER_01: So that's IDSA, J, and PIDS.
• 26:31
  SPEAKER_01: And it is funded by the CDC.
• 26:34
  SPEAKER_01: LEAP really, I think, proved its worth during the COVID-19 pandemic when the LEEP fellows truly served as health department intermediaries with other clinicians and participated in investigating, you know, so many critical concerns identified by their health departments about this new infection.
• 26:53
  SPEAKER_01: LEAP represents, I think, one of several new models for ID career development that hopefully will continue to be funded to fill this need moving forward.
• 27:05
  SPEAKER_01: And I this program is very near and dear to my heart because Massachusetts HAI AR program has been very fortunate to have uh three LEAP fellows over the last several years.
• 27:17
  SPEAKER_01: And the most recent one is currently positioned with our State Health Department.
• 27:21
  SPEAKER_01: And we have just learned so much from those fellows, and I think they have hopefully learned a lot from us as well.
• 27:28
  SPEAKER_01: And the the two the prior fellows that we had are both now working in positions where we have the opportunity to interact with them on a regular basis, which I think is fabulous.
• 27:40
  SPEAKER_03: Wow, thank you so much, uh Joe and Melissa.
• 27:43
  SPEAKER_03: Um, as we do in the hospital, let me read this back to you to see that uh I understand uh um the role of uh public health and antimicrobial resistance and HAI prevention.
• 27:55
  SPEAKER_03: So I I can my sense is that uh the role of public health in healthcare safety is wide-ranging.
• 28:00
  SPEAKER_03: While CDC holds limited regulatory powers, it seems to have great influence over healthcare safety and quality.
• 28:08
  SPEAKER_03: For example, CDC supports many activities related to developing guidance, prevention, monitoring, or investigating the occurrence of healthcare-associated infections, including antimicrobial resistance uh and antimicrobial resistant pathogens.
• 28:25
  SPEAKER_03: State health departments, on the other hand, have HEI programs that receive support from CDC through the ELC cooperative agreement mechanism.
• 28:34
  SPEAKER_03: This support dates back more than a decade and has grown considerably over the years as the value of HI programs has been increasingly recognized.
• 28:43
  SPEAKER_03: And uh no other time has that been more obvious than during the recent COVID-19 pandemic.
• 28:49
  SPEAKER_03: How does that sound to you?
• 28:50
  SPEAKER_03: Anything else that you guys would like to add?
• 28:54
  SPEAKER_04: I think that's really on the mark, Jorge.
• 28:56
  SPEAKER_04: Thank you.
• 28:56
  SPEAKER_04: Yeah, if I I mean if I was gonna add something, I would say, you know, um the HCI programs are really pretty unique in the ways that they help bridge public health and healthcare and bringing everybody together to really work towards uh you know single goals here in terms of maintaining and improving healthcare quality as it relates to communicable disease threats, you know, it's uh it's heartening to see this success.
• 29:19
  SPEAKER_04: And and I guess finally, you know, really encourage you know Shea members and other listeners to sort of lean into this idea of building partnerships between your hospital, your facility, and and your state or local HAI AR program.
• 29:34
  SPEAKER_03: Thank you, uh Joe, uh Melissa, and to our listeners of this uh Shea podcast.
• 29:40
  SPEAKER_03: Goodbye.
• 29:41
  SPEAKER_00: Thanks for listening to today's episode of the Shea Podcast.
• 29:45
  SPEAKER_00: Don't forget to register for the 2024 Shea Spring Conference, taking place April 16th to the 19th in Houston, Texas.
• 29:53
  SPEAKER_00: For more information and to register, visit Shayspring.org.