[Federal Register Volume 75, Number 184 (Thursday, September 23, 2010)]
[Notices]
[Pages 57958-57959]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-23762]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES


Solicitation of Written Comments on Draft Tier 2 Strategies/
Modules for Inclusion in the ``HHS Action Plan to Prevent Healthcare-
Associated Infections''

AGENCY: Department of Health and Human Services, Office of the 
Assistant Secretary for Health, Office of Healthcare Quality.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Office of Healthcare Quality is soliciting public comment 
on three new strategies or modules of the ``HHS Action Plan to Prevent 
Healthcare-Associated Infections.'' To further the HHS mission to 
protect the health and well-being of the nation, the HHS Steering 
Committee for the Prevention of Healthcare-Associated Infections has 
developed draft comprehensive strategies for preventing and reducing 
healthcare-associated infections in ambulatory surgical centers and 
end-stage renal disease facilities, as well as a strategy to increase 
influenza vaccination coverage among healthcare personnel. These Tier 2 
modules build upon and are to be included in the existing ``HHS Action 
Plan to Prevent Healthcare-Associated Infections'' that focuses on 
reducing hospital-acquired infections (Tier 1).

DATES: Comments on the draft Tier 2 modules should be received no later 
than 5 p.m. on October 11, 2010.

ADDRESSES: The draft Tier 2 modules can be found at http://www.hhs.gov/ophs/initiatives/hai/actionplan/index.html#tier2. Comments are 
preferred electronically and may be addressed to [email protected]. Written 
responses should be addressed to the Department of Health and Human 
Services, 200 Independence Ave, SW., Room 719B, Washington, DC 20201, 
Attention: Draft Tier 2 Modules.

FOR FURTHER INFORMATION CONTACT: Danielle Doughman, (202) 690-6476 or 
[email protected].

SUPPLEMENTARY INFORMATION

I. Background

    Healthcare-associated infections are among the leading causes of 
morbidity and mortality in the United States and the most common type 
of adverse event in the field of healthcare today. They are defined as 
localized or systemic adverse events, resulting from the presence of an 
infectious agent or toxin, occurring to a patient in a healthcare 
setting. An epidemiologic study by the Centers for Disease Control and 
Prevention (CDC) revealed that the subset of HAIs with hospital-onset 
accounted for 1.7 million infections annually and were associated with 
99,000 deaths in 2002. The fiscal cost is steep as well. Healthcare-
associated infections contribute to an additional $28 to $33 billion 
dollars in healthcare expenditures annually.
    For these reasons, the prevention and reduction of healthcare-
associated infections is a top priority for the U.S. Department of 
Health and Human Services (HHS). Multiple agencies within HHS have been 
working to reduce the incidence and prevalence of healthcare-associated 
infections for decades. To further efforts, the HHS Steering Committee 
for the Prevention of Healthcare-Associated Infections was established 
in July 2008 and charged with developing a comprehensive strategy to 
progress toward the elimination of healthcare-associated infections.
    In 2009, the Steering Committee issued the initial version of the 
``HHS Action Plan to Prevent Healthcare-Associated Infections.'' The 
initial strategy (Tier 1) focused on the prevention of infections in 
the acute care hospital setting and includes a prioritized research 
agenda; an integrated information systems strategy; policy options for 
linking payment incentives or disincentives to quality of care and 
enhancing regulatory oversight of hospitals; and a national messaging 
plan to raise awareness of HAIs among the general public, providers, 
and other stakeholder groups. The Action Plan also delineates specific 
measures and five-year goals to focus efforts and track national 
progress in reducing the most prevalent infections. In addition, the 
plan intended to enhance collaboration with non-government stakeholders 
and partners at the national, regional, state, and local levels to 
strengthen coordination and impact of efforts.
    Recognizing the need to coordinate prevention efforts across 
healthcare facilities, HHS began to transition into the second phase 
(Tier 2) of the Action Plan in late 2009. Tier 2 expands efforts 
outside of the acute care setting into outpatient facilities (e.g., 
ambulatory surgical centers, end-stage renal disease facilities). The 
healthcare and public health communities are increasingly challenged to 
identify, respond to, and prevent healthcare-associated infections 
across the continuum of settings where

[[Page 57959]]

healthcare is delivered. The public health model's population-based 
perspective can be deployed to enhance healthcare-associated infection 
prevention, particularly given the shifts in healthcare delivery from 
the acute care (Tier 1) to ambulatory (Tier 2) and other settings.
    Also, influenza transmission to patients by healthcare personnel is 
well documented. Healthcare personnel can acquire and transmit 
influenza from patients or transmit influenza to patients and other 
staff. Higher vaccination coverage among healthcare personnel has been 
associated with a lower incidence of healthcare-associated influenza 
cases. In addition, the proportion of healthcare-associated cases among 
hospitalized patients decreases as well, suggesting that increased 
staff vaccination can contribute to the decline in the number of 
healthcare-associated influenza cases.
    The Steering Committee has drafted two strategies or modules that 
address healthcare-associated infection prevention in ambulatory 
surgical centers and end-stage renal disease facilities. An additional 
module addresses influenza vaccination of healthcare personnel. Similar 
to its Tier 1 efforts, Tier 2 healthcare-associated infection reduction 
strategies expect to be executed through research and guideline 
development, implementation of national quality improvement initiatives 
at the provider level, and creation of payment policies that promote 
infection control and reduction in healthcare facilities.
    To assist the Steering Committee in obtaining broad input in the 
development of the three draft modules, HHS, through this request for 
information (RFI), is seeking comments from stakeholders and the 
general public on the draft Tier 2 modules. The modules can be found at 
http://www.hhs.gov/ophs/initiatives/hai/actionplan/index.html#tier2.

II. Information Request

    The Office of Healthcare Quality, on behalf of the HHS Steering 
Committee for the Prevention of Healthcare-Associated Infections, 
requests input on three drafts: ``Section A: Ambulatory Surgical 
Centers,'' ``Section B: End-Stage Renal Disease Facilities,'' and 
``Section C: Influenza Vaccination of Healthcare Personnel.'' In 
addition to general comments, the Steering Committee is seeking input 
on any additional gaps not addressed in the draft strategies.

III. Potential Responders

    HHS invites input from a broad range of individuals and 
organizations that have interests in preventing and reducing 
healthcare-associated infections. Some examples of these organizations 
include, but are not limited to the following:

--General public
--Healthcare, professional, and educational organizations/societies
--Caregivers or health system providers (e.g., physicians, physician 
assistants, nurses, infection preventionists)
--State and local public health agencies
--Public health organizations
--Foundations
--Medicaid- and Medicare-related organizations
--Insurers and business groups
--Collaboratives and consortia

    When responding, please self-identify with any of the above or 
other categories (include all that apply) and your name. Anonymous 
submissions will not be considered. The submission of written materials 
in response to the RFI should not exceed 10 pages, not including 
appendices and supplemental documents. Responders may submit other 
forms of electronic materials to demonstrate or exhibit concepts of 
their written responses. All comments received before the close of the 
comment period are available for viewing by the public, including any 
personally identifiable or confidential business information that is 
included in a comment.

    Dated: September 16, 2010.
Don Wright,
Deputy Assistant Secretary for Healthcare Quality.
[FR Doc. 2010-23762 Filed 9-22-10; 8:45 am]
BILLING CODE 4150-28-P