Identifying Gaps

ECRI Institute’s consulting helps providers respond to a multitude of issues related to infection control and prevention

On any given day in the United States, about 1 in 25 hospital patients has at least one healthcare-associated infection (HAI), according to estimates.

Indeed, there are quite a few areas that create vulnerabilities for infections at hospitals and health systems, said James Davis, MSN, RN, CCRN-K, HEM, CIC, FAPIC, Senior Infection Prevention & Patient Safety Analyst/Consultant, ECRI Institute.

For example, lapses in sterilization and high-level disinfection are especially concerning, he said. There are environmental and construction-related factors. Hand hygiene is a well-known concern for the spread of infections.

“ECRI’s engineering team has performed comparative evaluations in our testing laboratory of automated hand-hygiene devices and equipment to help hospitals know which products are best for reducing infection risks,” said Davis. “Other areas of vulnerability involve infection prevention program management, medical device issues broadly, as well as infection prevention considerations in the selection and procurement of equipment and devices.”

Consultation
ECRI receives a broad range of requests from hospitals and healthcare systems for infection prevention and control (IPC) consultation. To meet those requests, ECRI has developed an IPC consultation that is led by certified infection control-prepared experts with advanced degrees.

“Behind each consultant stands the power of ECRI’s full knowledge base of multi-disciplinary experts, making ECRI unique in these consultations,” said Davis.

ECRI Institute’s certified infection preventionists conduct onsite consultations, while ECRI staff of medical device engineers, epidemiologists, architects, accident and forensics specialists, and clinicians review findings and provide additional recommendations.

“For example, if we are onsite for an outbreak and the consultant suspects that that the potential reservoir is medical-device related, we immediately call in the expertise of the clinical engineering staff in our Health Devices group,” said Davis. “That instant expertise advises us, in real time, about the nature of the device and potential mechanisms that would put the device at risk for being a causative factor. If we need an engineer or a medical forensics expert onsite (or any other expert), we fly them out to get the job done right the first time.”

Davis said the ECRI Infection Preventionists look at a variety of inputs to develop the gap analysis and action plans from (but not limited to):

  1. Systems (physical and electronic)
  2. Devices (medical and standard)
  3. Mechanicals/plant engineering
  4. Staffing
  5. Workflow
  6. Infection prevention program effectiveness
  7. Data validation
  8. Surveillance techniques (manual and electronic)
  9. Epidemiologic data and analysis
  10. Human factors/ergonomics
  11. Cleaning and disinfection
  12. Sterilization/high level disinfection
  13. Environmental factors/industrial hygiene
  14. Infection control risk assessment for construction (consultation, planning, program evaluation, onsite and online training)
  15. Policy and procedure review
  16. Implementation science
  17. Infection forensics

“ECRI is basically a one-stop shop for infection prevention and control consultation and resources. “


ECRI has been updating its Coronavirus Outbreak Preparedness Center on a regular basis. The resources include very specific information on emergency preparedness supplies.


The following are best practices ECRI helps hospitals and health systems develop for better infection prevention:

  • Situational awareness processes, policies, procedures, supply procurement and facility risk assessment – (Ebola, SARS, Influenza, COVID-19)
  • Health IT: For example, modification of the electronic health record (EHR) to capture process and outcome measures for infection-related issues. The Partnership for Health IT Patient Safety, a multi-stakeholder collaborative convened and operated by ECRI Institute looks at these types of issues and our infection preventionists add to the content where/when appropriate.
  • Regulatory and certification preparedness and response to regulators/inspectors.