Implementing a participant-driven water management initiative to support Maryland hospitals

Hospital water systems are recognized as potential sources of waterborne pathogens, posing serious risks to vulnerable patient populations. Despite federal and local guidelines, implementing effective water management programs in healthcare settings remains a significant challenge.

From April 2024 to May 2025, the Maryland Statewide Prevention and Reduction Collaborative (SPARC) implemented a participant-driven learning collaborative, the Water Management Initiative, based on interest from infection preventionists at Maryland hospitals. The Water Management Initiative aimed to be responsive to the learning needs of Maryland acute care hospitals regarding their water management practices, as informed by an initial needs assessment. The initiative was evaluated via surveys after all sessions were completed.

Of the 42 eligible Maryland acute care hospitals, 26 (62%) responded to the pre-initiative needs assessment. Based on this assessment, SPARC developed the Water Management Initiative, which included a full-day workshop, 11 webinars, one office hour, and individual coaching sessions with two facilities. Following the initiative, 93% of postsurvey respondents (N = 13/14) reported implementing new or modified water management practices, and 77% (N = 10/13) of those respondents attributed these changes to their participation in the initiative. The proportion of respondents who indicated high confidence in conducting water management activities increased between the needs assessment and postinitiative survey.

SPARC's Water Management Initiative demonstrated that a participant-driven approach can increase knowledge regarding water management practices in healthcare settings. This initiative provides a replicable model for other states seeking to enhance healthcare water management through public health-academic partnerships, peer-to-peer learning, and multi-disciplinary team engagement.