NACCHO recognizes the DuPage County Health Department (Illinois), Healthcare Associated Infection (HAI) team as its latest Infection Prevention and Control (IPC) Champion. The DuPage County HAI team exists within the Communicable Disease and Epidemiology Unit at DuPage County Health Department. Team members include Rashmi Chugh, MD, MPH (Medical Officer); Elizabeth Murphy, MPH (Assistant Director of Communicable Disease and Epidemiology); Emily Murskyj, MPH (Epidemiology Supervisor); Zach Noffsinger, MPH (Disease Specialist); and Nora Ortinau, DVM, MPH (Epidemiologist). Over ten years ago, this team was established through support from both NACCHO and Centers for Disease Control and Prevention (CDC) to better identify and understand the impact of HAIs, multi-drug resistant organisms (MDROs), and extensively drug resistant organisms (XDROs) within their jurisdiction. The DuPage County Health Department is a leader in quickly and efficiently adapting their team to combat the growing threats of HAIs, especially in response to the evolving situation of COVID-19.
NACCHO’s IPC Champions are passionate, well versed, and respected leaders in the field of infection prevention and control. These individuals work at local health departments and advance infection prevention and control capacity, activities, guidelines, and engagement.
Impact at the Local Level: DuPage County Health Department
Historically, the DuPage County Health Department HAI team has engaged both onsite and remotely with long-term care facilities to conduct point-prevalence surveys, infection control audits and follow-up visits, and provide educational support and infection prevention guidance resources in conjunction with Illinois Department of Public Health (IDPH) staff. When the COVID-19 pandemic arose, the HAI team quickly shifted and expanded their focus to COVID-19 surveillance, investigation, and prevention and control activities in congregate healthcare facilities, educational settings, and business/workplaces in DuPage County. The HAI team provides consultation and support in the context of COVID-19 IPC, while emphasizing the core principles of infection prevention that reduce the overall burden of infectious disease in a facility.
The HAI team acknowledges the difficulties and concerns faced by facilities in implementing new practices or adjusting current practices due to time constraints, staffing shortages, and limited resources, particularly given that full-time dedicated infection prevention staffing in long-term care facilities is rare (less than 10% of facilities) in their jurisdiction. Another challenge the HAI team continues to navigate is the inconsistent buy-in and demonstrated commitment to infection prevention by medical directors, as most infection prevention responsibility falls disproportionately to the directors of nursing. Despite these challenges, they have improved relationships and responsiveness through regular outreach efforts and by continuing to identify partners and their team roles (e.g., medical director, infection prevention designee, director of nursing, environmental services) in their consultation and outreach efforts towards multi-disciplinary engagement. Internally, DuPage County Health Department functioned as a hub to receive and provide personal protective equipment (PPE) to facilities in their jurisdiction, particularly long-term care facilities who experienced extreme PPE shortages for several months.
The DuPage County Health Department HAI team recommends local health departments create a multi-disciplinary and action-oriented team that consists of members with expertise and experience in epidemiology, case investigation/contact tracing, infection prevention, and clinical practice. They also work with IDPH to promote opportunities for professional development and continuing education (e.g., the APIC long-term care certificate course, statewide annual antimicrobial stewardship summit) for long-term care facility staff.
“Change is difficult - have a plan for how your team will support culture shifts around infection prevention, antimicrobial stewardship, etc. in your partner facilities and counter resistance to practice changes. Everyone has been working very long hours, particularly during the COVID-19 pandemic, so remember to be kind and support positive activities for staff and other colleagues; a fun, quick ice breaker at the beginning of our weekly team meetings goes a long way in boosting morale!”
Impact on Health Equity in DuPage County
Beyond infection prevention and control challenges, the DuPage County Health Department is also committed to addressing health inequities. The DuPage County COVID-19 Health Equity and Access Response Team (HEART) was established through a partnership between the DuPage Health Coalition, DuPage Federation for Human Services Reform, Impact DuPage, and the DuPage County Health Department. HEART provides a countywide voice for health equity and access, ensuring that all residents of DuPage County reach the highest level of health possible.
The initial focus of HEART was to reduce the disproportionate impact of COVID-19 in communities and groups most affected by the pandemic, by incorporating efforts into the work of Impact DuPage. HEART has been active since October 2020. Their most recent priorities include supporting and coordinating vaccination clinics through community outreach, multilingual COVID-19 vaccine surveys to assess COVID-19 vaccine hesitancy and build confidence, and the recruitment of Health Ambassadors for public service announcements, interviews, and townhall meetings.
“We are most proud of the dedication, effort, and commitment shown by public health and healthcare staff across many months in our agency and our community.”
The DuPage County Health Department HAI Team continues to serve as a role model for their multi-disciplinary approach and rapid response efforts to reduce the overall burden of infectious disease in facilities through support to healthcare facilities and educational and business settings.