Orlando Health

Melissa Morgan

Infection Prevention Operator

Brief Background on Your Roles in the Organizations

I began my healthcare career as a paramedic before becoming a nurse. I have worked in multiple healthcare environments before transitioning to infection prevention. As an infection prevention specialist and leader, I have had the opportunity to influence women’s health, intensive care, medical, trauma, surgery, and ambulatory spaces approach to infection prevention. As the pandemic began, I gained great insight into local, state, and federal collaboration in infection prevention, as well as learned the challenges of county and state lines. Having worked in several large healthcare organizations on the East and West Coast has allowed me to gain great insights that influence my role and responsibilities each day.

Significant Trends in the Field Patient Safety and Care

The basics of infection prevention continue to be challenging. I have always said it is the free things that would eliminate the need for my job, but they are often the most difficult to gain compliance and understanding for as you do not usually see the consequence. From an infection prevention perspective, it is critical to engage with staff. Although there is a significant focus on staff shortages in both nursing and providers across the country, I believe staffing turnover impacts patient safety and care even outside these specific clinicians. Departments such as environmental services, who are the foundational infection preventionists, are also struggling with staffing. The electronic health record has helped us connect patient care through multiple providers, but what has been more impactful is the development of technology or providing care outside the traditional hospital setting. Historically, infection prevention programs have been hospital-based despite the continued expansion of most health systems into ambulatory settings. As technology has advanced and care is pushed outside the hospital setting, complex procedures that require specific infection prevention guidelines inside the hospital are now being performed in practice without infection prevention partnership and patient safety.

"Although there is significant focus on staff shortages in both nursing and providers across the country, I believe staffing turnover impacts patient safety and care even outside these specific clinicians."

Pressing Challenges in Overseeing Infection Prevention Programs

Infection prevention programs are influenced by the organization themselves as well as regulations. In my experience, healthcare systems lean toward ensuring resources for programs that drive improvement. Unfortunately, when the infection prevention program is not resourced adequately, the subject matter expertise can get lost as solutions tend to be focused on individual infection occurrence versus trend analysis or organism-specific indicators of practice gaps. Infection prevention is most valuable when they can be at the elbow of those doing the work. When managing an infection prevention program, understanding how the work is done has helped me develop strategies that involve products and technology. Resources do not always mean people are needed. For example, providing the infection preventionist with a mobile device can promote more rounding and interaction with direct patient care to influence immediate change and gain efficiency.

Innovative Technologies Implemented at Orlando Health

I think the innovation I am most excited about is the development of an app for the end user to access transmission-based precautions. Every organization I have worked for, as well as most colleagues I know, utilize the CDC Guideline for isolation precautions. This is a 206-page document that includes an appendix providing the type and duration of precautions. Most infection prevention programs use this guideline for policy and typically link or include the appendix. Unfortunately, I have found that clinicians struggle to access this information through a policy. This results in delayed precautions, exposures, and quite a bit of time involved in calls, messages, and follow-up. I built an app that allows for access on any mobile or desktop device that has Power apps by Microsoft Office suite available. It is super simple and only requires the user to know at least a few letters of what they are looking for, creating instant access for pertinent isolation precautions. With a culture of ‘we need an app for that,’ I built one.

Integrating New Best Practices in Disinfection and Sterilization Impacting Healthcare Facilities Operations and Protocols

Disinfection and sterilization are evolving at a rapid pace to improve patient safety, given the outbreaks that have made headlines over the last few years. This is where the influence and partnership with infection prevention can have the most value. Infection prevention can highlight for the organization that by spending the money to design a space that provides high water quality, appropriate environment, adequate space for cleaning and disinfection, and investing in innovative technologies, efficiencies can be realized that allow for more procedures resulting in increased revenues. This also reduces the cost of readmission and complications that are typically not a part of a new service line business plan but can be expensive to any organization as well as the impact on the patient.

Advice for Other Senior Leaders and CXOs Working in the Industry

My advice for senior leaders would be to understand what your infection prevention program is providing you by spending time with the department. Understand that they are more than just the hand hygiene police or the messengers of unwelcome news with an identification of healthcare-associated infection. Lean into understanding the experience and resources the program's leadership has, and provide them access to national resources to learn and grow as a leader so that they can help create the safest healthcare system possible.