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Infection Control in the Outpatient Setting

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Infection Prevention

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Abstract

As healthcare continues to evolve, economic forces and technological advancements have facilitated the transition of healthcare delivery from acute care hospitals to a myriad of different outpatient environments including ambulatory surgery centers, physician offices, dialysis centers, home healthcare, and other specialized settings (Friedman et al., Infect Control Hosp Epidemiol [Internet] 20(10):695–705, 1999). The number of outpatient visits in the United States in 2016 was 883.7 million or 278 office-based physician visits per 100 persons (Ashman et al., NCHS data brief: characteristics of office-based physician visits, 2016 [Internet]. Available from: https://www.cdc.gov/nchs/products/index.htm, 2019). The complexity and volume of surgical procedures performed in ambulatory surgical centers continue to rise, demonstrated by a 25% increase between 2006 and 2017 and $4.6 billion in Medicare expenditures in 2017 alone (MedPAC, Report to congress: medicare payment policy, ch. 5, “Ambulatory Surgical Center Services”, 2019). Outpatient oncologic care is also on the rise, with recent estimates indicating over 15 million people are currently living with cancer in the United States, corresponding to 1.1 million outpatient chemotherapy or radiation visits per year (National Cancer Institute, SEER cancer stat facts: cancer of any site [Internet]. Available from: https://seer.cancer.gov/statfacts/html/all.html, 2021; Halpern and Yabroff, Cancer Invest [Internet] 26(6):647–651, 2008). Various other outpatient healthcare settings such as urgent care clinics, dialysis centers, nutritional support centers, and outpatient parenteral antimicrobial therapy are also seeing increasing volumes of patients (Norris et al., Clin Infect Dis [Internet] 68(1):e1–e35, 2019). In the context of dynamic expansion of healthcare delivery in the outpatient setting, implementation of strong infection control practices has never been more relevant to ensure the safety of both patients and healthcare personnel. While considerable progress has been made, a heightened and sustained focus on the development of outpatient infection control infrastructure, surveillance, reporting, oversight, and monitoring is urgently needed. Beyond regulation, a culture of safety that embraces a proactive approach to healthcare-associated infection prevention, engaging a variety of stakeholders, is essential to facilitate collaboration and advancement.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Infectious Diseases, Virginia Commonwealth University Medical Center, Richmond, VA, USA

    Julie D. Boatman, Michael P. Stevens & John Daniel Markley

  2. Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, VA, USA

    Michael P. Stevens

  3. Infectious Diseases/Epidemiology, McGuire Veterans Affair Hospital, Richmond, VA, USA

    John Daniel Markley

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  1. Julie D. Boatman
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Correspondence to Julie D. Boatman .

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Editors and Affiliations

  1. VCUHS Epidemiology and Infection Control, Virginia Commonwealth University, Richmond, VA, USA

    Gonzalo Bearman

  2. Baltimore VA Medical Center, University of Maryland School of Medicine, Baltimore, MD, USA

    Daniel J. Morgan

  3. Division of Infectious Diseases, Cedars-Sinai, UCLA David Geffen School of Medicine, Los Angeles, CA, USA

    Rekha K. Murthy

  4. Infection Prevention and Control Department, University Health Network, Toronto, ON, Canada

    Susy Hota

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Boatman, J.D., Stevens, M.P., Markley, J.D. (2022). Infection Control in the Outpatient Setting. In: Bearman, G., Morgan, D.J., K. Murthy, R., Hota, S. (eds) Infection Prevention. Springer, Cham. https://doi.org/10.1007/978-3-030-98427-4_6

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