Background. The Colorado Pay for Performance (P4P) program provides funding to long-term care facilities that meet specific quality measures in antimicrobial stewardship (AS) and infection prevention and control (IPC). To support these initiatives, the Colorado Department of Public Health and Environment (CDPHE) partnered with the Department of Health Care Policy and Financing (HCPF) to deliver statewide training in implementation of AS and IPC initiatives to nursing homes and assisted living residences.
Method. We conducted two 90-minute virtual training sessions in June and October 2025. We collaborated with the Colorado Health Care Association and Center for Assisted Living (CHCA) and Telligen (a Quality Innovation Network-Quality Improvement Organization) to promote the events. The curricula focused on AS, catheter-associated urinary tract infection prevention, enhanced barrier precautions, and the Centers for Disease Control and Prevention’s Infection Control Assessment and Response tools. We used post-training surveys to evaluate content relevance, participant confidence, and future educational needs.
Results. A total of 210 participants from 130 facilities across 116 zip codes attended the June (n=116) and October (n=94) sessions, with five attending both (Figure 1). The most frequent roles included infection preventionists (26%), directors (18%), and registered nurses (16%) (Figure 2). Among 44 survey respondents, the most applicable topics were EBP, IPC modules, and personal protective equipment. The median confidence score for applying the training was 4 (range: 1-5). Respondents expressed the most interest in future training regarding EBP, AS, and multidrug-resistant organisms.
Conclusions. Linking public health training to existing P4P incentives enabled broad educational reach across a geographically diverse provider population. This interagency partnership successfully engaged a multidisciplinary workforce and increased participant confidence in implementing IPC and AS initiatives. This model demonstrates how leveraging financial incentives can effectively align state-level public health goals with facility-level quality improvement.
