LEAP Curriculum

LEAP strives to have all fellows experience these activities during the fellowship year. 

• Adverse Event/Sentinel Event Debriefing — Deliver debriefing of an adverse event, ideally one related to ID, such as a health care-associated infection (HAI), sentinel SSI or sepsis death. 

• Safety and Quality Committee Meeting(s) — Attend and observe a safety and quality committee meeting, and gain exposure to hospital safety metrics, hospital scorecards and department/division improvement reporting. 

• Incident Command Center Opening — Attend and observe how a hospital incident command center functions, and how reporting and communications are managed during crises (includes modified incident command infrastructure, e.g., for COVID-19 response). 

• Hospital Accreditation Survey/State Licensing Survey Preparatory Rounds/Meetings (aka Tracer Rounds, Survey Audits) — Get to know how accreditation surveys proceed, what data are viewed/gathered, how hospital locations and divisions are examined and prepared, and the ID physician’s role during surveys. 

• Media Communications Training — Leadership in infectious diseases often requires communication with news agencies and other lay press about topics such as community outbreaks, communicable diseases or emerging infectious diseases. It is strongly encouraged that fellows request media training through their hospital’s communications department. 

LEAP strives to have all fellows experience these activities during the fellowship year. 

• Health Department Personnel Shadowing (e.g., Health Care-Associated Infections (HAI) Program Coordinators, Medical Directorate, Outbreak or Communicable Disease Personnel, Stewardship Personnel) — Fellows will shadow department personnel during field work and coordinating meetings. Many fellows spend one or more days a week at their health department site. Key topics include HAI program structure at the health department, types of funding utilized by the health department and how different funding is utilized, and the CDC’s role in health department funding and programming. 

• Programmatic Advisory Councils (HAI Advisory Council, Stewardship Advisory Council) Experience — Fellows learn about the information tracked by advisory councils and how that information is used to inform public health department activities. 

• Facility Infection Control Assessment and Response Visits & Debriefs — Through site visits, fellows learn how an ICAR functions, including types of information and issues that are identified as well as subsequent recommendations. Most fellows participate in more than one ICAR visit, ideally to different types of health care facilities, such as acute care hospitals, critical access hospitals, ambulatory surgical centers or other outpatient settings such as long-term care facilities and hemodialysis facilities.  

• Reportable Disease Reviews (CRE, CRAB, Candida auris, COVID-19, XDRO TB, STIs) — Fellows attend health department meetings where reportable diseases are discussed to learn how the health department approaches tracking and management of concerning infectious and communicable pathogens. 

• Public Health Lab Visits and Meetings — Fellows visit health department-affiliated public health labs to learn about typical activities, services provided to facilities around the state and how the lab determines what kinds of tests to use in which circumstances (such as when PFGE or whole-genome sequencing is appropriate for clonal analysis). 

LEAP strives to have all fellows experience these activities during the fellowship year. 

• Core Stewardship Program Work Meeting — Fellows participate in the regular workgroup meeting for their hospital’s stewardship program. Learning points include how stewardship programs monitor antimicrobial use, how the efficacy of ASP interventions is monitored, how ASP programs address antimicrobial use concerns by leadership and day-to-day activities conducted by the stewardship program. 

• Participate in Prospective Antimicrobial Use Reviews and Feedback Interventions — Participate in prospective auditing of antimicrobial use. Learning points include how to communicate stewardship recommendations with various types of providers. 

• Prepare Antimicrobial Use Reports — Assist in the creation and compilation of antimicrobial use and antimicrobial stewardship program activity reporting. Learning points include what and how metrics of antimicrobial use and patient day denominators are collected and compiled, and what other data are collected and tracked by an ASP including (if relevant) antimicrobial resistance data or antibiogram data, intervention tracking and national reporting. 

• Creation of Antimicrobial Use Guidelines (or Clinical Treatment Guidelines) — Participate in the creation of new antimicrobial use guidelines or clinical treatment guidelines. Learning points include what kind of data goes into compiling a new treatment guideline, what the process is for approving and disseminating this type of guideline, and how to utilize pharmacokinetic and pharmacodynamics information to inform recommendations. 

• Antimicrobial Stewardship Educational Efforts — Participate in AS educational lectures or other educational efforts. Learning points include how to most effectively convey stewardship recommendations. 

• Antimicrobial Stewardship and Microbiology Joint Meetings — Learn how the ASP program works with microbiologists to influence susceptibility reporting (tiered susceptibility reports/tiered resistance testing), rapid diagnostic reporting and diagnostic stewardship (if any). Understand the lab’s role in hospital formulary review and antimicrobial approvals, creation of the hospital antibiogram and specialized susceptibility test reporting for newly introduced antimicrobial agents.   

LEAP strives to have all fellows experience these activities during the fellowship year. 

• Core Infection Prevention/Hospital Epidemiology Program Work Meetings — Fellows participate in the regular workgroup meeting for their hospital’s infection prevention/hospital epidemiology program. Key learning points include how health care-associated infections are monitored, how the efficacy of interventions is monitored, how HAI concerns are addressed by the infection prevention program, and what day-to-day activities infection preventionists and hospital epidemiologists engage in. 

• Tracking Metrics — Fellows will learn and understand how infection prevention programs obtain and track numerators and denominators in their surveillance programs. 

• HAI Review — Fellows will participate in the HAI review process and understand the CDC NHSN definitions. They will participate in HAI case adjudication meetings and learn NHSN surveillance definitions and how they differ from clinical criterion. 

• HAI Cluster/Outbreak Workup — Participate in at least one HAI cluster or exposure workup during the fellowship. Learning points include how to create a proper case definition and retrospectively identify potential cases, data needed to create a case detail listing (i.e., line list), how to appropriately select controls and how to create an epidemic curve. Fellows learn how to utilize exposure ratios, relative risk, and odds ratios and confidence intervals in appropriately selecting cases and controls, as well as how to approach multidisciplinary case workup and interventions. 

• Surgical Observation — Fellows participate in at least one surgical procedure observation in the context of surgical site infection prevention. Fellows learn about the types of potential surgical infection risks, the interventions used to minimize them and the types of SSI surveillance systems. 

• Environment of Care Rounds — Fellows participate in at least one EoC assessment where they learn what types of environmental hazards are examined by infection prevention and what hospital departments oversee maintaining a safe environment for patients. 

• Participate in an Infection Control Risk Assessment — Fellows learn how infection preventionists assess a location’s infection risk and how that influences the types of infection control measures needed for that area. 

• Shadowing of Infection Preventionists — Fellows shadow infection preventionists and learn about their daily activities, including what types of surveillance they perform and their hospital roles in HAI prevention and education.