By Phenelle Segal, RN, CIC, FAPIC, Founder, Infection Control Consulting Services
Key Takeaways
Healthcare facilities do not have to choose between hiring a full-time infection preventionist and contracting with a consulting firm. In many cases, the two work best together.
A full-time infection preventionist hire costs more than salary alone. Recruiting, benefits, credentialing, and ramp-up time all add to the real cost.
Contracting with a consulting firm gives a facility access to a full team's combined experience, not just one person's knowledge.
The right approach depends on facility size, survey timing, current staffing, and budget.
I hear this question from facility leaders regularly: Should we hire a full-time infection preventionist, or do we bring in outside support? Having worked with facilities ranging from small ambulatory surgery centers (ASCs) and imaging centers to multi-site hospital systems, I can tell you there is no single right answer. It depends on the facility. But there are some things leadership should carefully weigh before deciding.
The Real Cost of Hiring a Full-Time Infection Preventionist
A salary is only part of what a facility pays for a full-time infection preventionist. Benefits, paid time off, and ongoing education add up quickly. Certification through a program like CIC, with more specialized credentials like CAIP available for ASC-focused practice, takes time and money, and it needs to be maintained year after year.
Then there is the hiring process itself. Recruiting for infection prevention roles can take months or longer, especially in smaller markets. Once someone is hired, they need time to learn a facility's specific policies, history, and culture before they can work at full capacity. They may even need to fit in knowledge gaps about the type of facility, depending on their background.
Turnover, which is high within the field of infection prevention, makes this worse. If an infection preventionist leaves, a facility can be left without dedicated coverage right when a survey is approaching. I have seen this exact gap put facilities at real risk more than once.
Even after a new infection preventionist is hired, they need onboarding and mentoring to get up to speed on a facility's specific history, policies, and survey findings. That transition period takes time no matter how experienced the new hire is.
Many facilities also run into a more basic problem: Infection prevention responsibilities get added to someone's existing clinical or administrative role. That person is doing their best, but infection prevention was never meant to be a side project. It requires focused time and specialized knowledge.
What Contracting an Infection Control Consultant Looks Like
Bringing in an infection control consulting firm can solve several of these problems at once. Instead of relying on one person's training and experience, a facility gains access to an entire team. At ICCS, our consultants come with extensive backgrounds, covering areas including sterile processing, water management plan development, and antimicrobial stewardship, and they receive ongoing support from other infection prevention experts. A single new hire cannot offer that same breadth on day one.
Contracting is also flexible. A facility can bring in support for a one-time risk assessment, request ongoing survey preparation, or set up a hybrid model that combines both. This lets a facility scale support up or down as needs change, rather than committing to a fixed headcount regardless of workload.
And if a consultant ever needs to step away, the facility is not left without support. A team-based model does not depend on a single individual staying in place indefinitely.
When Hiring In-House Still Makes Sense, and How Consulting Fits Alongside It
Larger health systems with high daily patient volume and multiple sites often do need a dedicated, full-time infection preventionist. The day-to-day workload at that scale calls for someone embedded in the organization full time, and I would never tell a facility otherwise.
Even in that case, a consulting partnership still has real, measurable value. A newer infection preventionist can benefit from mentoring and onboarding support from someone who has done this job for decades. An experienced infection preventionist can benefit from a second set of eyes on a risk assessment or a mock survey. And even a strong internal program can run into gaps in specialized areas like outbreak investigations or remote HAI surveillance and NHSN reporting support, areas that often fall outside what a generalist infection preventionist handles day to day.
Coverage during leave is another common use case. When an infection preventionist takes parental leave, medical leave, or simply moves on to a new role, a consulting firm can step in and keep the program running without a lapse.
The choice, in other words, is not always hire or contract. Many facilities get the most value from doing both.
How to Decide: Hire, Contract, or Both?
A few questions can help guide the decision of whether to recruit an infection preventionist or partner with an infection control consulting firm:
Where does the facility stand in its survey cycle right now?
Does current staff have the bandwidth to take on infection prevention responsibilities, or is it already being absorbed into another role?
Would the facility rather budget for a fixed salary or scale spending based on actual need?
Is the facility large enough, and complex enough, to justify a full-time hire, or would flexible support serve it better?
If there is already an infection preventionist on staff, are there specific gaps where outside expertise would help?
Facility type matters here too. ASCs and imaging centers often feel the "added to someone else's job" problem the most, since they tend to run leaner staffing models. Hospitals and critical access hospitals are more likely to already have an infection preventionist on staff, but they can still run into specialized gaps that outside support fills well. In my experience, federally qualified health centers (FQHCs) often face some of the tightest staffing constraints of any facility type we work with, which makes flexible support especially valuable.
Final Thoughts
I have worked with facilities of every size on this exact question, and the right call always comes down to the same things: current staffing, budget, and where the real gaps sit. For some facilities, a full-time hire is the right call. For others, contracting gets them where they need to be without the overhead. And for many, the best answer is a combination of both.
Infection prevention is too important to leave understaffed or under-supported, whichever direction a facility chooses.
If you are weighing this decision for your facility, I invite you to contact us for a complimentary consultation. My team and I can help you think through what makes sense for your specific situation.
Frequently Asked Questions About Hiring vs. Contracting for Infection Prevention Support
Can a contracted infection control consultant meet CMS and accreditor requirements the same way an in-house infection preventionist does?
Yes. CMS, AAAHC, the Joint Commission, ACHC, QUAD A, and DNV all evaluate whether a facility's infection prevention program meets requirements, not whether that program is run by an employee or a consultant. A qualified consulting firm can build, run, and document a program that satisfies the same standards.
How quickly can a contracted consultant get up to speed on our facility?
This depends on the facility's size and complexity, but an experienced consulting team can typically begin meaningful work within the first few weeks of an engagement, starting with a review of current policies and an initial risk assessment.
Can ICCS support a facility that already has a full-time infection preventionist on staff?
Yes. We regularly work alongside existing infection preventionists, providing mentorship, second-opinion risk assessments, specialized program development, and coverage during leave or transitions.
What does a hybrid engagement, combining internal staff with outside consulting, typically look like?
A hybrid model often means an internal staff member handles day-to-day infection prevention tasks, while a consulting firm provides periodic risk assessments, survey preparation, specialized plan development, or backup coverage as needed.
Is contracting more cost-effective for smaller facilities than larger ones?
Smaller facilities often see the clearest cost advantage, since they may not have the patient volume to justify a full-time salaried position. Larger facilities can still benefit from contracting, typically alongside an internal hire rather than instead of one.