Efforts to reduce the spread of health care-acquired infections are showing progress. The Centers for Disease Control and Prevention, for example, reports a 70 percent sustained reduction in central line-associated blood stream infections due to the practice of evidence-based guidelines. Yet there's more work to be done. About one in every 20 patients contracts a health care-acquired infection, posing a significant risk to patient safety and adding more than $30 billion in cost to the health care system.

Evidenced-based practices go a long way toward infection prevention. But hospital design and infrastructure also play significant roles. "Hospitals have to have all of the components in place if they are to eliminate infections," says Judene Bartley, vice president, Epidemiology Consulting Services, Beverly Hills, Mich., and clinical consultant, Premier Safety Institute. "A well-designed patient room goes a long way toward preventing infections."

Single patient rooms and improved air filtration systems can prevent transmission of infectious agents. But it's not necessary to build a new facility or undertake expensive renovations, says Kirk Hamilton, a professor at Texas A&M University, College Station. "Patient care areas should be designed so caregivers can freely move around the patient," he says. Limiting clinician contact with surfaces in patient rooms and easing access to supplies reduces the opportunity of spreading infection.

Design also can support hand hygiene, considered the most important practice to stop hospital infections. "It's kind of basic, but the placement of hand sanitation dispensers and sinks can improve hand hygiene," says Linda Dickey, director of epidemiology and infection prevention at the University of California Irvine Medical Center. She says simple technologies can help, such as attaching motion sensors to lights so they shine on a sink or hand sanitizer station when someone enters a patient room.

Executive support is essential to infection prevention efforts, notes Bartley. "There has to be visible involvement," she says. Reducing infections is the right thing to do from a patient safety standpoint, but it's also linked to reimbursement and patient satisfaction.

"The investment in effective design is increasingly important as health care organizations face constraints in resources due to the transformation of the care delivery system," Bartley adds.