Q&A: APIC’s New CEO Welcomes Unprecedented Challenges

Devin Jopp, EdD, MS, has been the chief executive officer of the Association for Professionals in Infection Control and Epidemiology (APIC) for all of about six weeks now. He knew what he was getting into, how much the health care industry leans on infection preventionists (IPs) as never before as coronavirus disease 2019 (COVID-19) cuts a deadly path through society. When asked if he has any second thoughts, Jopp laughs. “I have to admit, I’m very mission driven and focused,” he tells Infection Control Today®. Jopp talks about the challenges of guiding a profession that in the perhaps near future may not be confined to just the hospital setting. Aside from the immediate conundrums that COVID-19 presents to IPs (for instance, convincing the public and even fellow health care professionals to get the vaccine), there’s the demographic challenge that about 40% of IPs will retire within the next 10 years. There are also the problems that not every state requires infection preventionists be certified, that far too few health care institutions offer infection prevention as a career path, or that even fewer universities teach it. Infection prevention is still too often something that somebody might drift into. “We have a big issue with replacement,” says Jopp. “And we have a bigger issue with expansion of the field to fill the need. But I think again, it’s going to be really working with trying to become a lot more open in terms of making sure that we explain how to become an IP, making it available with residency opportunities and that combination of degree and certificate programs.”

Infection Control Today®:What’s the main message and want to put it out there to infection preventionists?

Devin Jopp, EdD, MS: I think the role of the importance of the infection preventionist in really helping us to defeat and to beat back COVID-19. And I think we’ve really relied on infectious preventionists as being our eyes and our ears and our experts on the ground. And so, I think really helping to bolster all of you and your efforts to combat COVID-19 in your facilities and outside of the facilities is going to be crucial. And really trying to also work together with you all to advocate for what we need to help support this. And we know there are all kinds of issues out there, from the lack of PPE to vaccines and the challenges of getting those in the right hands and dealing with some of the resistance that’s out there among our patients, our health care workers. There are lots and lots of challenges but know that we’re here with you and be working with you together.

ICT®: You’ve only been on the job about six weeks and you jumped in during this world altering pandemic. Did you have any thoughts?

Jopp: I have to admit, I’m very mission driven and focused. And actually, I was working at American College Health Association, which represented all the college health centers and mental health centers on college campuses. I was very involved in developing the roadmap, documents around college campuses reopening. If you remember the discussion about whether to reopen campuses or not. I wasn’t afraid of COVID-19 in terms of jumping in with both feet. And when I saw APIC, I thought it was a great opportunity to come and to serve an organization that is serving so many others and making a difference. I’m really pleased to be here and to join in arms together in the fight here.

ICT®: I’ve talked to experts who think that infection prevention expertise, and even infection preventionists themselves, will migrate beyond the confines of the hospital. Are there enough infection professionals to go around?

Jopp: One of the big issues we have out there is that we need more infection preventionists. I think we need to really work hard on trying to…. Where are we going to source all these new infection preventionists? We also have a lot of baby boomers that are infection preventionists

Devin Jopp, EdD, MS

that rose up obviously through the ranks. With their retirements, we obviously have kind of a workforce replacement issue. I think the first answer is, no, I don’t think we have nearly enough infection preventionists and as we look at trying to expand the industries where we may be called to serve, I think it’s going to be a real issue. To your second point on where we need to expand. I think we’re at the beginning phases of really seeing a dramatic expansion of our profession. You mentioned things like hospitality or fitness, the travel industry. Even in fact right now, some of our IPs I’m aware of are actually working with entertainment companies right now looking at trying to make sure that they’re safe on the sets. We actually work with the United Brotherhood of Carpenters; actually provide training to them already. I think from sports teams to hospitality to construction sites, to many, many more, the infection prevention field will absolutely be bulging and I hope that we can really count on our policymakers to really put in resources and support this critical path needed to get us up to a level that we’re going to need for staffing to support it.

ICT®: Samantha Smathers, the system director for infection prevention and control at the Children’s Hospital of Philadelphia, created a career path there for infection preventionists to follow based on APIC’s guidelines. What she saw was that an infection preventionist on the job for 25 minutes would be expected to do the same job as an infection preventionist on the job for 25 years. Would you like to see career paths for infection preventionists become more of a reality in hospitals?

Jopp: I think it’s a multi-level piece. I think there’s what we can do within institutions to make it a career path. And I think also, before we even get to talking about institutions around it, how are we looking at the development through a higher education perspective? I think one of the challenges and one of the blessings, frankly, of being an infection preventionist is they come from multiple fields now. We have nurses, we have public health, we have med tech backgrounds. Us understanding where we actually have potential sources for infection preventionists allows us to start building some pathways. I hope that we continue to see more degree programs, certificate programs that are helping to provide external training. And then I think within organizations, like hospital systems, for example, we really need to go and look at our career pathways and say, “How do we make sure that we describe what we do, and that we get it out there to those rising up through the ranks to see it as a career path.” Almost like a mentorship program. APIC has some curricula that it is doing. It’s actually designing a residency program that we’re going to be pushing out to our members as well. I think the other piece that is less well defined is we talked about expansion into other industries. What does that look like where we may not have any infection preventionists today? Helping to really look at how do we actually stir that and build those pathways to go building that infrastructure in place where it may not even exist today?

ICT®: Within the next 10 years about 40% of infection preventionists will retire. That’s a pretty daunting demographic challenge. Have you been thinking about that? How do you get younger people interested in infection prevention?

Jopp: I think there’s obviously going to be a very large number, as I mentioned earlier, with baby boomers retiring, and really the profession was built on many of them. Really, the profession started in the early ’70s. As they matriculate out—and this is why I think higher education is going to be important too—building some career pathways to help make it easier to get individuals into the program and to start learning is going to be really crucial. We have a big issue with replacement. And we have a bigger issue with expansion of the field to fill the need. But I think again, it’s going to be really working with trying to become a lot more open in terms of making sure that we explain how to become an IP, making it available with residency opportunities and that combination of degree and certificate programs.. I actually really also hope that coming out of this pandemic—and we’re actually starting to see this—I just read an article that Ohio State’s nursing program is bulging. They have a lot of students that now want to become nurses because of the pandemic. And I hope that infection prevention can really inspire others to really get involved because the work our members are doing is heroic. And I think that message, if we can get it out, will inspire a whole new generation of IPs to really get involved and make a difference.

ICT®: Infection prevention certification is not required in all states. Is that one of your goals? Making IP certification a nationwide necessity?

Jopp: Absolutely. I think one of the real misses here is that we have not had all 50 states uniformly pushing for CICs, for the designation for ensuring that we actually have them in all of our institutions, particularly long-term care. I think as we look at new legislation that’s rolling out, one of the things I was just talking about this morning was a need for model legislation and language, particularly for long-term care, as we’re looking for trying to get other states to really take action. If we get it right, we can really prevent deaths in the future. Using that CIC and getting that written in I think is really important work that we have to do from a legislation side with the states.

ICT®: I always had the impression that infection preventionists saw themselves as a profession as being sort of pushed out of the loop. That they’re taken for granted except of course when a pandemic strikes. Has COVID-19 changed that view and also the view of the profession from outside?

Jopp: I think it has and I think it can be very dependent sometimes on the organization you’re dealing with. And in some places—many places—the infection preventionist has been really relied upon as being the expert and helping to really deal with the response and then being on the incident response teams. In some, they haven’t, and you’re left with why. And in some cases, there are a whole host of reasons why, but they can also be sometimes the perceptions, or the lack of infrastructure around IPs that may not have existed in that institution yet. Sometimes it’s even lack of awareness among the executive leadership. One of the things, obviously, that I think COVID-19 does is it creates kind of this rallying cry in this need to elevate the profession and ensure that the C-suite understands what it’s doing. Because the value that they bring in helping to mitigate and respond to these kinds of [crises] is really crucial. Does it change it forever? I’m a little bit of a cynic in terms of what happens over time, as people forget as the decades click on. While we have a fresh memory, we need to make a lot of change. Now, we always have to keep working and reminding ourselves about the importance of infection prevention. I think the last pandemic was 1918, right? And while we had some near misses before, I think this one does give us an opportunity for short-term consciousness change. But we really have to follow it up with long-term system change that really ensures that IPs are at the center and then the forefront going forward for all of these kinds of responses.

ICT®: One of the experts I speak to is Michael Millenson, and Michael is not known for mincing his words much. The first time I talked to him, he said it’s an absolute disgrace how health care has basically ignored the problem of infections in health care facilities. He said that the Centers for Disease Control and Prevention (CDC) hasn’t done nearly as much as they should have done over the decades. And then the second time I talked to him was after the CDC launched Project Firstline, the $180 million effort to teach infection prevention rules to people on the frontlines, not just infection preventionists. Do you feel that Project Firstline maybe dilutes infection prevention and that it should be run through infection preventionists and they should be the ones doing the educating or are you happy for the help?

Jopp: I look at it this way. I don’t think it’s fair to kind of hold the CDC to the standard. I think the one issue that we’ve seen over a long decade and more—multi-decades—is really the lack of investment in public health infrastructure. And that’s all the way to state health departments, and local and county health departments. And so, over the years, if we’ve made all these budget cuts…. And I think it’s because, again, we weren’t taking pandemics seriously as one of the threats. Then, we made these cuts. I think all things considering the CDC has done as good a job as they can with what they were given. Now, I think the issue of whether or not Project Firstline takes away from or enhances our work. At the end of the day, I think we can’t begin to nearly teach enough people to help with infection prevention. I personally say, “Bring it on. Let’s teach everybody.” And our job is made easier. Because we win when we have smart consumers, when we have smart coworkers. When we have everyone knowledgeable about this, our job gets inherently easier. Our goal is to really eliminate health care-associated infections. I think the training and doing more is always better than doing less. And while I guess the argument could be made that you’re pulling out of one pocket versus the other, I think that collective effort together is far more powerful.

ICT®: And it might have the happy byproduct of getting younger people interested in pursuing infection prevention as a career.

Jopp: Absolutely. An important part of what we’ve got to do. We’ve got to inspire a whole new generation of IPs to get involved. And we’ll find them from all walks of life and all different paths,

ICT®: Is there something that I neglected to ask that you think may be pertinent and something that you want infection preventionists to hear?

Jopp: As I look ahead, obviously, I think the vaccine is one of the big issues that we’re starting to see now. And so, I think with all of you out there…. Really as we’re starting to track and figure out what—particularly with health care workers—what kind of resistance are we running into. Trying to really work together to figure out how we can best get that messaging out and make sure that IPs can be a potent voice for really helping to get vaccines in arms. Because ultimately, that’s the way we get to enough immunity, and really kind of help advance our way out of COVID-19. So, we’re going to be doing a lot of research around that. We actually are about to release a survey around this resistance. But I think that’s just another area. And I think the final area I want to talk about is burnout. I think that’s an area that I know [Infection Control Today®] covered and we’re appreciative. What [infection preventionists] are going through right now is extraordinarily difficult. We’re so grateful for your efforts. And the physical and mental strain that it takes is a real sacrifice. And so, I think trying to continue to work to provide methods and ways and ideas to help our IPs deal with their own well-being as they’re taking care of others is going to be crucial. And that, again, as an association, that’s a focus area for us. To make sure that we’re taking care of our own while we’re taking care of others.

This interview has been edited for clarity and length.