ISSUE: A bill to mandate nosocomial infection (NI) reporting has been introduced in the Virginia General Assembly (VGA) during four annual sessions. In 3 previous years, APIC-VA worked to defeat the bills. Each year the patron of the bill became less accommodating to the members. This year, by applying epidemiologic methodology and working with stakeholders, APIC-VA wrote a bill with the Virginia Department of Health (VDH) which was enthusiastically substituted by the patron in lieu of his original bill.

PROJECT: In first year, infection control professionals (ICPs) met with the patron, attended legislative committee meetings, and sent sporadic e-mails to the committee members. The bill was ultimately tabled. In the second year, ICPs waged a more aggressive e-mail campaign but otherwise continued the same approach. Again, the bill was tabled. By the third year, we were savvier regarding the workings of the VGA; we met with every delegate or aide on the subcommittee, asked each chapter member to send e-mails to the delegates, and attended the legislative committee meetings. The patron became more adversarial and barely recognized the ICPs during the subcommittee session. The bill was again tabled.

RESULTS: A collaborative effort produced a statewide survey of ICPs on surveillance activities that gave us evidence about what could be reported. The survey results and activity of other states' legislatures and the Consumers Union were reviewed. APIC-VA developed an alternative plan for mandatory reporting that provided sound methodology but was more limited in scope than the original bill, which required reporting of all NIs. ICPs contacted the original bill's patron and asked to meet with him, with the idea of working with, not against, him. ICPs also met with other key House members. The patron's response was completely different; he listened to the results of the study, asked for our recommendations, including ways to minimize financial impact and the impact on ICPs. The bill, which was collaboratively written with VDH based on our survey results and not on other groups' recommendations, was ratified by the House and will be presented to the Senate in 2 weeks.

LESSONS LEARNED: Apply what you know, review current practice and the literature, draw sensible conclusions, and report those conclusions to the appropriate groups. As experts in infection control, don't be reactive and obstructive; instead, take ownership of the issue and proactively create a solution.