Dear Helpdesk: Shifting the Role of "IPC" Police From Enforcers to Partners

Dear Helpdesk: Inoculating Your Work Life with IP Wisdom by Infection Control Today.

Dear Helpdesk,

How can we stop the micromanaging from the C-suites and upper management? They don't understand what we do and try to make us the IPC [infection prevention and control] police.

Sincerely,

“IP Police”

An infection preventionist speaking with another health care worker.

(Image credit: Author)

Dear “IPC Police,”

I had a strong visceral reaction when I read your question. I suspect most IPs reading it now had the same response. Being seen or viewed as a weapon is the last thing we want, an image we work very hard to avoid.

I can only imagine the dread you feel when an edict comes down from your C-suite or senior leadership, tasking you with policing a department and the expected steps and outcomes. As infection preventionists (IPs), we see our role as supportive. We aim to unite people and overcome barriers, not weaponizing people or process errors, influencing change through fear of reprisal.

That said, the experience you mention is not uncommon, and we collectively try to avoid it.

Now, let's move on to some practical advice to help you.

Step 1: It is important to consider the source of micromanagement. Generally, leaders micromanage because they fear, are anxious, or are insecure about achieving a desired outcome and lack trust in the team.

Step 2: Understand how your senior leadership sees your role. Are you wearing that police badge daily? Or is your wearing it instigated by a regulatory finding, poor quality metric, or frustration that the team tasked with addressing the issue failed to complete it successfully? These questions probe the heart of a critical issue in many health care organizations: The perception of IPs. Are they proactive partners in patient safety or reactive responders to crises?

Step 3: Reflect on your organizational culture. How have IPs been treated historically? How has this conversation been brought up in the past? How was it received? Step Four: once you have reflected on these, consider who you might initiate a discussion with in the organization. How comfortable do you feel chatting with your medical directors or direct leadership about this? If possible, start there.

Step 4: Construct the messaging. Once you have identified someone with whom you can have a safe and open discussion, consider how being the “IP Police” negatively impacts the organization's mission and IPs' ability to affect positive change.

For example, suppose staff were instructed to conduct hand hygiene observations, document nonadherence, and report these findings to unit leadership for staff follow-up. While the intent was to improve hand hygiene adherence, this approach can alienate staff, damage relationships, and ultimately undermine the program's effectiveness.

Reflect on instances where you were directed to take on a similar role. How did these directives potentially hinder the organization's mission? What underlying reasons might have prompted leadership to assign these tasks? Rather than adopting a punitive approach, IPs can be instrumental in fostering a culture of safety and compliance. Share how IPs can empower staff to make positive changes by shifting the focus to education, coaching, and collaboration.

Step 5: Building on that initial conversation, who are influential people within your organization you can contact for support?

Consider starting with your closest partners, who they would recommend reaching out to and soliciting support from. If we continue with the example from Step 4, mandatory hand hygiene audits to ensure compliance, what unit directors have the lowest hand hygiene adherence? Consider partnering with unit directors who are open to collaboration and firmly commit to patient safety.

Image of 2 women running beside each other. One, in color, is smiling with others cheering for her; and the other, in black and white, is not smiling, and no one is cheering for her.

(Image credit: Author)

Approach these conversations with empathy and understanding, seeking to identify the root causes of nonadherence. Some common barriers may include heavy workloads, staffing shortages, and lack of awareness. Have an open conversation to understand the obstacles specific to their unit. Extend an invitation to conduct hand hygiene rounds with unit staff and leadership. Educate on how to provide on-the-spot coaching and education to family and visitors. Use these units as your pilot study to demonstrate the value of a collaborative approach.

Share the wins in the appropriate venues, such as nursing leadership meetings, infection prevention, and quality meetings recognizing the work of key contributors, celebrating the accomplishments to remove barriers to hand hygiene, and the power of influence to make positive change.

Putting it all together, implementing cultural change is a gradual process that requires many strategic victories to drive progress. Select your allies carefully and engage with influential individuals who will champion your message. Assess the organization's receptiveness to change and identify opportunities for process improvement that can reshape its image—leverage committee meetings to propose alternative approaches and showcase your successes.

Please see our recent article, Effective Change Management for Infection Preventionists in a Constantly Evolving Health Care Landscape, to learn more about how IPs leverage change management techniques to overcome resistance, build momentum, and implement infection prevention strategies to safeguard patient health and organizational efficiency in health care settings.

By positioning yourself as an asset and demonstrating your worth, you can reshape the perception of your role. A strong track record of achievements and the support of key stakeholders will foster trust and credibility. Over time, you can transition from being seen as the "IP police" to a trusted advisor and subject matter expert.

Remember, as you drive positive change, it is crucial to prioritize self-care to prevent burnout. You can create a sustainable and supportive work environment by modeling healthy behaviors and encouraging others to do the same. One effective strategy is to set realistic goals and break down large projects into smaller, manageable tasks. This approach helps prevent the team from becoming overwhelmed and allows regular recharge breaks. Changing organization culture or how your C-suite sees you is a marathon, not a sprint. By building your support system, practicing, and training with a solid team, you become an expert at change management and somebody people want to cheer for.

Warm regards,

Dear Helpdesk