Legionella and other waterborne pathogens are of great concern for healthcare systems.
The Center for Medicare and Medicaid Services (CMS) issued a memorandum requiring
a reduction of Legionella and other opportunistic waterborne pathogens in healthcare
facility water systems. A Water Management Team (WMT) was implemented in 2019 in a
newly constructed 55-bed acute care facility due to lack of a formal program and to
proactively prevent infection in the patient population.
An acute care facility collaborated with a third-party vendor to initiate a water
management program (WMP). Key stakeholders collaborated and performed verification
and validation strategies including environmental water sampling, water flushing,
and active surveillance in high-risk areas. The first round of testing showed viable
Legionella growth in multiple samples. The site implemented several actions to eliminate
the viable Legionella without success. It was found that the Ultra-Violet light system
that was installed on cold water prior to supplying the hot water loop was dropping
chlorine levels from the city very low. A chlorine injection system was installed,
and regularly scheduled water sampling was completed. The WMT collaborated to bring
concerns and issues to key areas and departments as well as executive leadership to
facilitate discussion and decision-making regarding the safety and operation of all
potable water systems.
Following the last intervention, the environmental water sampling showed no growth
for viable Legionella. There were no reported hospital-acquired Legionella cases reported
during this time frame.
A multidisciplinary WMP reduced the site's risk for healthcare associated Legionella
as evidenced by results of water surveillance and supported by infection control surveillance.
A WMP is a fundamental component to meet CMS mandates and address Legionella prevention.