Flattened Management Structure: New Idea for a Progressive Acute-Care Infection Control Department

ISSUE: Infection control management is a complex paradigm. Conventional methods of hierarchy in acute-care hospitals often have a manager or a single infection control professional (ICP) supervised by the hospital epidemiologist(s). Additional ICPs usually report to the manager. With the age of the average ICP at 58 years, it is imperative to train newcomers to this ever-growing field, which is fundamental to todayʹs healthcare goals of patient safety. PROJECT: The Johns Hopkins Hospital is a 1000-bed acute-care hospital with seven full-time ICPs, five of whom have >10 years experience in infection control and supporting areas including microbiology, occupational health, acute care, long-term care, surgery, safety, grant management, and public health. The two “new” ICPs are being mentored by experienced staff members in a variety of infection control aspects. We developed an “MOD” (manager on duty) model which allows us to manage ourselves and our program while still getting critical input from the hospital epidemiologists. In this model, each experienced ICP manages the department on a 2-week rotational basis, as well as carries the 24-hour emergency beeper for the department during that period. RESULTS: This paradigm empowers the ICPs to direct significant parts of the infection control program while still meeting the outcome goals of upper management, e.g., appropriate surveillance data and interventional epidemiological results. This model also promotes cross-training in different areas of infection control needs by virtue of handling the beeper and enhances management experience. LESSONS LEARNED: Self-management has facilitated the growth of a highly visible, empowered, cohesive team that accomplishes more together than separately. We have been able to identify areas of staff performance needing improvement and have planned together to improve these problems.