Introduction

BACKGROUND: The widespread prevalence and enormous cost of healthcare–associated infections (HAIs) constitute a major public health problem and patient safety concern. OBJECTIVES: In 2009, IMPAQ International and the RAND Corporation initiated an independent, outside evaluation of Health and Human Services' HAI prevention efforts as guided and driven by the Action Plan. The 3-year evaluation, whose findings are presented in this special issue, was intended to assess the outcomes of the US Department of Health and Human Services' (HHS's) past efforts, and also to provide ongoing, formative feedback to Action Plan leadership to guide their efforts. RESEARCH DESIGN: This special issue presents results from the evaluation of the Action Plan, along with related articles intended to examine the issue of HAIs from many angles. RESULTS: To address the national epidemic of HAIs, in 2009 HHS released the HHS National Action Plan to Prevent Healthcare-associated Infections, which was updated and expanded in 2012. The Action Plan established national goals for HAI prevention and identified key actions needed to reduce, prevent, and eventually eliminate the burden posed by HAIs. CONCLUSIONS: Broad lessons learned from the Action Plan evaluation document changes in structures, processes, and outcomes pertinent to eradicating HAIs, and identify lessons that are applicable to other large federal implementation efforts.