[Federal Register Volume 77, Number 141 (Monday, July 23, 2012)]
[Notices]
[Pages 43086-43087]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-17925]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Solicitation of Written Comments on Draft Phase 3 Long-Term Care 
Facilities Strategy/Module for Inclusion in the National Action Plan To 
Prevent Healthcare-Associated Infections: Roadmap to Elimination

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

ACTION: Notice.

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SUMMARY: The Office of Healthcare Quality is soliciting public comment 
on a new long-term care facilities strategy/module of the National 
Action Plan to Prevent Healthcare-Associated Infections: Roadmap to 
Elimination. 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 a draft comprehensive 
strategy for preventing and reducing healthcare-associated infections 
in long-term care facilities. This Phase 3 Long-Term Care Facilities 
module builds upon and is to be included in the existing National 
Action Plan to Prevent Healthcare-Associated Infections: Roadmap to 
Elimination that focuses on reducing healthcare-associated infections 
(HAIs) in acute care hospitals, ambulatory surgical centers, and end 
stage renal disease facilities and presents strategies for increasing 
healthcare personnel influenza vaccination coverage (Phases 1 & 2).

DATES: Comments on the draft Phase 3 Long-Term Care Facilities module 
should be received no later than 5:00 p.m. Eastern daylight saving time 
on August 22, 2012.

ADDRESSES: The draft Phase 3 Long-Term Care Facilities module can be 
found at http://www.hhs.gov/ash/initiatives/hai/actionplan/index.html#tier3. Comments are preferred electronically and may be

[[Page 43087]]

addressed to [email protected]. Written responses should be addressed to the 
Office of Disease Prevention and Health Promotion, 1101 Wootton 
Parkway, Suite LL100, Rockville, MD 20852, Attention: Draft Phase 3 
Long-Term Care Facilities Module.

FOR FURTHER INFORMATION CONTACT: Debra Nichols (240) 453-8264 or 
[email protected].

SUPPLEMENTARY INFORMATION:

I. Background

    HAIs 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 approximately one 
in twenty hospital patients contracting an HAI. The fiscal cost is 
steep as well. HAIs 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 HAIs 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 HAIs.
    In 2009, the Steering Committee issued the initial version of the 
National Action Plan to Prevent Healthcare-Associated Infections: 
Roadmap to Elimination. The initial strategy (Phase 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 released Phase 2 of the 
Action Plan in late 2010. Phase 2 expands efforts outside of the acute 
care setting into outpatient facilities (ambulatory surgical centers 
and end-stage renal disease facilities). Phase 2 of the Action Plan 
also addressed strategies to increase influenza vaccination coverage 
amongst healthcare personnel as 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; and higher vaccination coverage among 
healthcare personnel has been associated with a lower incidence of 
healthcare-associated influenza cases.
    The healthcare and public health communities are increasingly 
challenged to identify, respond to, and prevent HAIs across the 
continuum of settings where healthcare is delivered. The public health 
model's population-based perspective can be deployed to enhance HAI 
prevention, particularly given the shifts in healthcare delivery from 
the acute care (Phase 1) to ambulatory (Phase 2) and now to long-term 
care facilities with Phase 3.
    The Steering Committee has drafted a strategy or modules that 
address HAI prevention in long-term care facilities, specifically 
nursing facilities and skilled nursing facilities. Similar to its Phase 
1 & 2 efforts, Phase 3 Long-Term Care Facilities 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 draft module, HHS, through this request for 
information (RFI), is seeking comments from stakeholders and the 
general public on the draft Phase 3 Long-Term Care Facilities module. 
The modules can be found at http://www.hhs.gov/ash/initiatives/hai/actionplan/index.html#tier3.

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 the draft: ``Long-Term Care Facilities.'' 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: July 17, 2012.
Don Wright,
Deputy Assistant Secretary for Health.
[FR Doc. 2012-17925 Filed 7-20-12; 8:45 am]
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