A Day In The Life Of An APIC Board Member

Some of you will know that as a recreational hobby I am a keen cyclist. (the photo above is 16 of my fellow team members and myself at 6am this morning as we headed out for 2 and a half hour ride thorugh the rainforest). It’s a sport that I was encouraged to take up since moving to the Gold Coast, in southern Queensland, Australia in 2004. There have been a ton of fantastic physical benefits that I’ve enjoyed since taking up riding –fitness, flexibility, agility, balance and mindfulness. More importantly I’ve learnt an enormous amount about the value of teamwork. So in this posting I want to spend some time describing the team dynamics and explaining how my cycling experiences have helped me develop a  deeper appreciation for APIC and the many teams that contribute.

OK back to the bike. When I started out riding I knew nothing and I had no skill and no fitness. Within 2-days of riding a big clunky wide-wheeled recreational bike to the local coffee shop I spotted a flock of lycra-wearing cyclists. They each had a strange swagger as they headed up to the counter to order their coffees. (I later learnt the fine art of walking in cleated cycling shoes – I also learnt how failing to “click out” of your shoes at a traffic light invariably leads to a fall and some serious grazes, as well as hurt pride).

These same lycra-wearers invited my partner and I to join their table and after a few weeks of coffee they’d offered advice about trading in our bikes and upgrading. We did exactly that and so with thinner wheels and lighter frames  on our new hybrid bikes, (ie half mountain bike half road bike) we started to increase the frequency of our rides and the distance we covered. In those early days a 20-30 minute ride was about all we could muster but the whole time our cycling friends encouraged us, offering handy hints and providing critique of our cycling work. No-one ever laughed at us or made fun of us, rather they just kept telling us how good it was to ride, what beautiful adventures were just around the corner and importantly how everything we did in that year was setting us up for the next.

In February 2006 my father passed away somewhat unexpectedly and his death was a huge wake-up call to me. It made me realise that life is short and precious, that good health and physical activity matter and that his gene pool was not fabulous. To celebrate his life we upgraded to racing bikes. These are the ones that have rams horn handlebars and very thin wheels and even lighter frames. All the while our lycra friends were cheering us on. On lighter bikes and with some increased fitness we had a better chance of being part of the team and so we started riding more and more in groups or “packs” as they are more commonly called here. Tuesday, Thursday, Saturday and Sunday mornings we headed out – up hills, over bridges, through rainforest, along the beach, across the river, down the freeway, on the plane – you name it, our bikes took us there.

A wonderful new world opened up to us and as it did we realised how important it was to be part of a team. When you are riding in a pack it’s critical that you keep an eye on the rider ahead, you stay close so you can be pulled along in their draught but not so close that you “clip their wheel” and cause an accident. You also have to place your faith in the leader of the pack. The leader is the person out the front of the pack. Their job is to set the pace so that everyone can keep up and maintain a forward direction. The leader also keeps their eyes wide open, scanning the environment for oncoming traffic and scouring the road for pieces of debris and fallen trees obstacles such as potholes or glass.

The leader follows the signs – when they say STOP the pack STOPs, when the path is clear and it’s safe the leader calls “CLEAR”. The pack places their faith in the leader and they each follow but cautiously they also scan their environment and reaffirm the leader’s calls to those that follow behind them. Best of all in any good ride the person leading the pack changes, that’s how you avoid fatigue and how you develop up the leadership skills of novices. New leaders have to earn the trust and the respect of the pack.

A thoughtful leader doesn’t change the pace unless the environment calls for it. The new leader may lead in their own style but they always read the signs of the environment knowing that their main task is to deliver the pack safely back to the end of the ride which is often a coffee shop. A good leader also knows when they are fatiguing and asks for support and to be relieved. They rely on the pack for feedback and for inspiration.

If the pack is well lead the wheels turn well. The ride is smooth and the scenery absorbed. The rides can be exhilarating and action packed, they can also be calm and relaxing. Usually the pack negotiates the agreed pace at the beginning of the ride and that’s what the pack sticks too. If any member of the pack experiences difficulty such as a flat tyre or a wobbly seat a call goes up “flat tyre, stopping” – it reverberates back to the last rider and the pack stops their ride only beginning when the comfort and safety of all riders is assured. Throughout the ride pack members call “all on” and subtly you check to see that all who started out the ride are keeping up. If not the leader reviews the pace and gives everyone a chance to re-group.

As I explain  my interpretation of a great ride you may see the similarities between being a good and fair APIC leader and a good and fair leader of a group ride. The basic skills and approaches are very similar and while it is infrequent that I ever have the bike handling skills and athletic speed to lead my riding pack I truly hope that my experiences of being lead several times a week will continue to guide me and inspire me as I work towards being the best leader that I can for APIC. I hope that you’ve enjoyed this analogy and if any of you are riders let me know and please feel free to share any tips and tricks.

Here’s to good leaders, strong respectful teams and safe rides in and external to APIC!

This posting is being thrown out on Wednesday 10th September as I sit at Brisbane airport waiting to board a plane for Los Angeles, on to Atlanta and then ending up in Savannah for 3 days where I am attending the AVA Conference. It will be my first AVA meeting but I notice that the meeting has some great presentations relating to infection including reports from Dr Ruth Carrico, PhD who serves on the APIC Board and Dr Marcia Ryder and eminent researcher into biofilms and a keen contributor to APIC. It will be great to catch up with both of my colleagues. After Savvanah it”s a quick hop on the plane up (I think up) to Orlando where the APIC Board is spending Sunday through Tuesday with invited key opinion leaders at the Fourth APIC Futures Summit. The Annual Futures Summit provides a great opportunity to think-tank and brainstorm ideas that will hopefully build upon APICs 2012 Strategic Plan and also guarantee the best alignment with members and the rapid growth and diversity of Infection Prevention. As Chair of the APIC 2008 Strategic Planning Committee I am excited and enthusiastic about the Summit.  The Summit ends on Tuesday and I will spend 30 hours re-tracing my journey this time flying through Dallas to LA and onto Brisbane. Funnily enough I will miss the day of Wednesday next week all together due to date line and time zone effects. If I counted all the days I’ve missed traveling the Pacific since my early 20’s I think I’d still only be about 25 years old rather than my chronological age, which should never be published on the WWW. So it’s a busy few days for APIC, the Board and the staff from Washington. Their commitment to the organization is outstanding and they make every part of the journey worthwhile. The other great part is catching up with friends old and new, nothing brings APIC members together better than working towards a common goal. I’m hopeful that after this Summit we will have new vigour and vitality for APIC members including some further clarity through very contemporary and smart strategies similar to those we’ve worked with so successfully these past few years. Gotta fly, literally….stay well and keep the comments rolling. I like knowing that at least some of you are enjoying this blog.  Cath “the flying kangaroo” www.qantas.com.au 

I am thrilled to formally announce my candidacy for the 2009 APIC Elections.  Growing up in the suburbs of Sydney, Australia in the early sixties I could never have imagined the wonderful and rich life that lay ahead. With good support from a loving family, fantastic partner and precious friends many great opportunities have been available to me. Few are as exciting, challenging and rewarding as the potential opportunity to  work with the APIC members and leaders as an elected President. The APIC Nominating and Awards Committee and Board of Directors have endorsed my candidacy and elections typically begin in early September. As for all elections candiates are faced against each other. In this case whilst I don’t personally know the other candidate, Pat Kulich, we have exchanged several warm e-mails. I wish Pat the very best in her efforts to lead APIC and I celebrate that our organisation is fortunate to have two strong and committed members to select as potential Presidents. Far better than not having enough.  2008 will be an interesting year for electing officials in America. I hope that the APIC election adds to that interest and who knows it could be the year that previous trends are overturned. Are we ready for a non-US APIC President, I sure hope so. For your interest my philosophy and biography as they will appear on the slate are reproduced below. Good voting and best of luck to Pat.

Biographical ProfileAssociate Professor Cathryn L Murphy RN, MPH, PhD, CIC, MRCNA, holds an academic position in the Faculty of Health Services and Medicine, Bond University, Australia. In 1995-96 she was the elected President of the Australian Infection Control Association and subsequently a Founding member of the Asia Pacific Society for Infection Control (APSIC). She is currently serving a second term as the only active non-North American member of the APIC Board. Dr. Murphy’s career highlights include working in the Division of Healthcare Quality and Infection Prevention at the CDC, Georgia, USA in 2000 and for WHO throughout Southeast Asia during the height of the 2003 SARS Outbreak. She managed the largest state government HAI Prevention and Control Program in Australia from 1997 until December 2004 with programmatic responsibility for more than 200 hospitals. She is currently an independent, international consultant. In 2006 WHO invited Cath to join its Infection Control Expert Advisory Network. In 2007, the Australian Commission for Safety and Quality in Healthcare invited her to chair their Infection Control Implementation Committee. This committee is similar in function and reach to the USA’s HICPAC Committee. Widely published, Dr. Murphy is a member of the Editorial Boards of the Australian, American and IFIC Journals of Infection Control. She delivers provocative and powerful presentations with respect, humor and compassion. Personally Cath is a novice but committed tri-athlete. She subscribes to the philosophy “Love what you do and do what you love”, hence her long-term commitment to infection prevention. Her “Life is Good” and she dreams of global infection prevention harmonization.

Philosophy Statement

Although infection prevention drivers and practices vary greatly between countries ICPs around the world face similar opportunities and challenges. Imagine a world where ICPs worked in global harmony. A world where infection prevention success and innovations are celebrated. Where infection prevention frustrations are heard, criticisms acknowledged and improvements introduced. A world where like-organizations cooperate to provide safer care and much needed education. A world where healthcare workers are afforded their rightful protections against infectious disease. A world where governments, payors, corporations and citizens recognize APIC members as the world’s leading source of infection prevention expertise and capacity. As APIC members we can craft and nurture this world. It is the natural progression of an organization whose membership has invested the last forty years in refining our work, progressing our achievements and empowering our profession. As APIC President I will help the membership realize this world domestically in the USA and abroad.

 Having worked as an ICP in several different continents and across a range of settings – clinical, government, academic and commercial, I will continue to bring unique perspectives and new offerings to the APIC table. Moreover I will continue to respect and celebrate APIC’s rich history, the legacies of its previous leaders and the consolidation of its bright future. Most importantly, through cautious leadership and thoughtful succession planning I will endeavor to ensure the APIC organization, its Board and its staff continue to understand and meet the many needs of its current and future members. North American APIC has made a difference. Global APIC can make a bigger difference. Electing Cath Murphy as your first non-North American APIC President is more than just a symbolic gesture. It marks the beginning of a new global era for APIC. Visit www.cmurphy.com.au to learn more about my commitment to the APIC membership. 

In 2008 there are more countries with dedicated local and/or national programs designed to reduce or eliminate healthcare associated infections (HAIs) than at any other time in history. Interestingly the global infection control stage is becoming more crowded as non-traditional players including claim infection control expertise at either individual or organisational level. High level campaigns of global magnitude are becoming more common and regional organisations such as the Asia-Pacific Society of Infection Control (APSIC) continue to grow in membership size and influence. Additionally, the WHO has signalled its intention to establish multiple Infection Control Collaborating Centres. More interestingly, some see US-based organisations such as the Association for Practitioners in Infection Control and Hospital Epidemiology (APIC) and the Centers for Disease Control and Prevention (CDC) as continuing to have substantial influence in shaping our profession. Recent provocative US lead initiatives such as the impending change to reimbursement and the promulgation of the title “Infection Preventionist” will inevitably also influence the growth and direction of Australian infection control. I would strongly encourage all Australian ICPs to stay abreast of recent, critical global infection prevention trends and initiatives as well as they will inevitable impact us.      

The July 23rd, 2008 edition of The Sydney Morning Herald (see image above) carried a lead story about the intentions of the New South Wales Health Minister to publically release identifying healthcare associated infections (HAIs) data and rates from NSW Public hospitals. What an incredible piece of news and what far reaching implications it could have for Australian and regional infection prevention.

Many of you will be aware of efforts in the US over the past few years where various legislature has been enacted compelling states to submit and publically release their specific HAI data. You may also note that APIC through its leadership, membership and Government Affair’s experts, has continued to raise public and political awareness about HAIs and infection prevention. The APIC website details this recent history well at www.apic.org It is likely that Australian progress will be similar but not identical to our US and British infection prevention peers. However this unfolds I can’t help but recognise that Australian infection prevention is on the cusp of its most recent wave - may it be a great ride.

Below I have copied the content of a recent posting I made to our AICA E-discussion List in relation to this development. Few AICA members have commented but I am sure that each has a response to this initiative.

Since yesterday afternoon two very important infection prevention events have occured. Each will have national impact. The first is the release by the Australian Commission on Safety and Quality on Health Care (ACSQHC) of their Surveillance Report. I have reproduced part of an e-mail sent by the Commission to stakeholders yesterday. I would also strongly encourage AICA members to provide comment to ACSQHC individually and collectively from your state and national perspectives. This is a critical opportunity to influence the future direction of Australian infection prevention efforts.The second event is a frontline story in today’s Sydney Morning Herald where the NSW Minister of Health has responded to the Commission’s publication by indicating that within 3 months NSW will release hospital-identifying healthcare associated infections (HAI) data. Many of you will know that NSW Health has had this information available to it for all public hospitals since January 2003. Whilst there are undoubtably methodological issues which impact the validity and reliability of the NSW data (like every other large HAI data collection system in the world) this is a monumental development.It has the potential to change the way we do business and especially to change the expectations of healthcare consumers. I have closely watched the US public reporting debate unfold since late 2004 and I suspect Australia’s path will be equally challenging. If NSW does release this data routinely every other jurisdiction will likely follow. Our profession is under the microscope well and truly.