National home care standards urged.

176 CMAJ, February 8, 2011, 183(2) © 2011 Canadian Medical Association or its licensors orient themselves with a lot of resources and a lot of sophistication. What do you do with a solo GP? Or even a multi-group practice?” Infection prevention and control in Canada has been focused on acute care facilities as a consequence of rising rates of health care–associated infections, which are now estimated at 220 000 per year, according to a study conducted by members of the Canadian Hospital Epidemiology Committee, the Canadian Nosocomial Infection Surveillance Program and Health Canada. While several provinces have created advisory committees and adopted measures aimed at reducing hospitalacquired infections and the Canadian Patient Safety Institute has rolled out a nationwide hand-hygiene campaign, most efforts have not been focused on health care facilities other than hospitals. It’s problematic, explains Dr. Mark Joffe, senior medical director of infection prevention and control for Alberta Health Services. For one, Alberta Health Services can’t tell a doctor how to run his or her private practice, Joffe says. And with limited resources, it makes sense to concentrate on areas in the health-care system where infection can do the most damage, which historically has meant a focus on acute care hospital settings. But Joffe says that increasingly, there are “more and more people involved with infection prevention and control in continuing care or nursing homes. That’s a developing area.” As well, the Canadian Patient Safety Institutes will be bringing its “wash your hands, wash your hands, wash your hands” message to primaryand home-care providers across the country, says CEO Hugh MacLeod. It will also release the findings of a research project into patient safety in primary care and aim to change the culture by encouraging patients to ask doctors about infection prevention and control measures. “They [doctors] shouldn’t be offended if someone says, ‘have you washed your hands?’” MacLeod says. “It’s making everybody safe. It’s in everybody’s best interest.” While regulatory initiatives to implement infection prevention and control measures in the offices of family doctors are embryonic, at best, they are not entirely unheard of. The Alberta College of Physician and Surgeons, for example, has begun to conduct infection control audits of private practices. Ward expects the college will proceed with some form of its infection prevention and control program in the coming months. “Infection prevention and control has not diminished in its importance, in the eye of the public, and the public health office and government. There is the ever-present threat of pandemic infections. We need to test everyone’s readiness for those events. Will physicians’ offices be safe places to visit during a pandemic? It will take a continuous educational campaign.” — Emily Senger, Toronto, Ont.