Healthcare Clinical Brief

The Challenge of HAIs for Hospital Leaders

Healthcare-associated infections (HAIs) remain a significant threat to patient safety, financial performance, and hospital reputation. These infections increase patient morbidity, prolong hospital stays, and drive up healthcare costs—costing U.S. hospitals an estimated $28.4 to $45 billion annually.¹ C. difficile infections alone cost hospitals approximately $25,000 per case and contribute to Medicare penalties under the Hospital-Acquired Condition (HAC) Reduction Program.² Under this CMS program, hospitals in the worst-performing quartile for hospital-acquired conditions—including HAIs—face up to a 1% reduction in overall Medicare reimbursements.⁵ Infection data is submitted quarterly through the CDC’s National Healthcare Safety Network (NHSN) and publicly reported via the Care Compare platform.⁶

HAI rates are not just clinical metrics—they’re reputational risks that influence public trust, media coverage, and competitive standing. Infection rates are publicly reported, scrutinized by The Joint Commission, and factored into hospital safety grades and rankings such as those from U.S. News & World Report and The Leapfrog Group.³^,⁴ In today’s digital age, infection concerns shared through online reviews or social media can rapidly erode confidence in a hospital’s brand. Persistent outbreaks may lead to unit closures, decreased referrals, and regulatory investigations, creating mounting pressure on hospital leadership to demonstrate a proactive infection control strategy.³^,⁴

Evolving the Response: From Manual to Modern 

Hospitals have traditionally relied on manual disinfection and hand hygiene to control infections. While essential, these approaches alone leave gaps in coverage and are prone to human error. Ultraviolet (UV) disinfection systems, including UV-C and pulsed xenon, have gained popularity for supplemental disinfection in hospitals across the U.S. Hospitals have adopted UV systems to supplement manual cleaning while reducing labor associated with manual chemical disinfection. Despite their popularity, the real-world efficacy of UV systems is increasingly questioned. Studies report limitations in pathogen reduction due to UV's reliance on line-of-sight, poor shadow penetration, limited distance of light intensity, and the need for multiple repositionings.³^,⁵ In clinical settings, these shortcomings often result in inconsistent disinfection performance, particularly in cluttered or shadowed environments. In contrast, the alternative technology of aerosolized hydrogen peroxide is starting to gain traction within hospitals because aerosolized hydrogen peroxide systems provide uniform room coverage with higher germicidal efficacy and documented pathogen elimination.³^,⁶ The following table contrasts UV and aerosolized hydrogen peroxide systems and explains why aerosolized hydrogen peroxide systems are a compelling solution for modern hospital disinfection. 

Aerosolized Hydrogen Peroxide Comparison with UV Disinfection 

The Latest Technology - Automated Aerosolized Hydrogen Peroxide Systems

Within the last few years, advances in technology have enabled the introduction of automated aerosolized hydrogen peroxide systems to enhance hospital room disinfection. Smart connected wireless technology and digital data platforms can now be combined with aerosolized hydrogen peroxide technology to enable a leap forward in streamlining hospital infection prevention. Automated aerosolized hydrogen peroxide systems offer the labor-saving advantages of UV systems, combined with the additional benefits of whole room coverage and science-driven clinical evidence of germicidal efficacy against hard-to-kill pathogens. While UV struggles with shadowed areas and requires repeated repositioning, aerosolized hydrogen peroxide uniformly fills a room with micron-sized droplets, ensuring consistent coverage without the need for operator intervention. Common applications within a hospital environment include the following:

• Operating room and surgical suite bio-decontamination

• Terminal cleaning and isolation room disinfection

• PACU, oncology, and long-term acute care units

• Outbreak containment and proactive deep cleaning

Treating a hospital room with an automated aerosolized hydrogen peroxide system requires very little labor and alleviates EVS staff from arduous tasks and chemical exposure. Also, with full room disinfection cycles of less than 15 minutes, a hospital room can be turned over more quickly than alternative methods. A typical whole-room supplemental disinfection process using automated aerosolized hydrogen peroxide equipment typically includes the following steps:

• Perform regular cleaning of soiled surfaces and waste, linen replacement, etc.

• Place the automated aerosolized hydrogen peroxide system within the room, initiate operation, and leave the room during the countdown time

• Leave the room closed off for the aerosolized hydrogen peroxide contact and dissipation time (typically 15 minutes) - upon completion, the room is fully disinfected and ready for re-entry

• Reopen room and move aerosolized hydrogen peroxide equipment to next room or return to EVS storage

As an added benefit of the latest smart-device technology, connected aerosolized hydrogen peroxide  systems can integrate within data platforms to provide historical data on equipment usage, aerosolized hydrogen peroxide dosages, room coverage, disinfection times and locations to improve processes and provide auditable records. Some disinfection data platforms will integrate within hospital operational software platforms to provide system-wide hospital data and process management.

An aerosolized hydrogen peroxide example - Breezy Blue^®

Breezy Blue® is an example of next-generation touchless aerosolized hydrogen peroxide disinfection. Unlike slower vapor-based systems, Breezy Blue® rapidly distributes micron-sized aerosol droplets throughout the room using high airflow, allowing effective surface deposition while enabling shorter overall treatment cycles. The rapid aerosolized hydrogen peroxide dissemination allows the hydrogen peroxide droplets to evaporate quickly, allowing hospital rooms to be fully disinfected with 5-log germicidal efficacy within 15 minutes. Because the disinfection cycles are short, the room does not require sealing or any other time-consuming preparation. Optional environmental verification sensors can further validate hydrogen peroxide exposure during treatment to support quality assurance and protocol optimization.

Breezy Blue® is used with EPA-registered hydrogen peroxide-based disinfectants such as Breezy HaloSpray™. When used with hospital-grade Breezy HaloSpray™, Breezy Blue® offers broad germicidal efficacy (bacteria, viruses and fungi), is residue-free, low odor, and is safe for use around sensitive hospital equipment.¹¹

A Connected Hospital example - Breezy Cloud™

Breezy Blue® leverages the advantages of the latest technology of smart connected devices integrated with a data platform. Breezy Blue® integrates with Breezy Cloud™, a data warehouse with user dashboards for disinfection statistics, to simplify workflows for environmental services (EVS) staff and to provide verified compliance data. All Breezy Blue® and Breezy Cloud™ connectivity is accomplished outside of the hospital IT infrastructure, providing more data segregation and inherent protection of any sensitive hospital data or systems. Breezy Cloud™'s automatic recording and other features include:

• Treatment location, time, and dosage

• Disinfectant and equipment usage statistics

• Operational validation and status

• Compliance logs for audits

• API integration with RTLS and hospital platforms

Breezy Cloud™ supports hospital quality programs, Joint Commission readiness, and system-wide performance tracking. For example, Breezy Cloud™ provides exportable logs showing disinfection events by room, treatment durations, and compliance trends over time—useful for both internal audits and CMS reporting.

Conclusion

HAIs pose a critical operational and reputational risk for hospitals. Automated aerosolized hydrogen peroxide systems offer a leap forward in streamlining hospital room disinfection with traceable logs for audit compliance. For hospital leaders, this represents a strategic opportunity to improve safety, reduce costs, and protect institutional reputation.

Automated aerosolized hydrogen peroxide systems provide hospitals with an evidence-based approach to improving supplemental room disinfection while reducing workflow complexity and strengthening documentation. Breezy Blue® and Breezy Cloud™ combine automated whole-room disinfection with connected documentation to help modernize infection prevention through validated efficacy, simplified workflows, and measurable operational benefits, including:

Clinical Efficacy: aerosolized hydrogen peroxide is validated by peer-reviewed studies for its effectiveness against high-risk pathogens.

   - AJIC Study: Demonstrated >99.9999% reduction of C. difficile, MRSA, and VRE.⁷

   - Automated Disinfection Overview: Supported the superior coverage and efficacy of aerosolized hydrogen peroxide over UV-C.⁸

   - SARS-CoV-2 Study: Showed 100% elimination of viral RNA from air and surfaces post-aerosolized hydrogen peroxide treatment.⁹

   - Mold/Fungal Study: Verified elimination of Aspergillus spp. in healthcare settings.¹⁰

Ease of Use: One-button operation with automated dosing, minimal operator interaction, and no equipment repositioning.

Total Coverage: Fills the entire room with uniform micron-sized aerosolized hydrogen peroxide droplets with dosage options between 4-log and 6-log germicidal efficacy.

Operational Efficiency: Thorough whole-room disinfection can be completed in less than 15 minutes, allowing hospital rooms to be turned over quickly.

Automated Workflows: Reduce variation between operators to achieve more consistent implementation of disinfection protocols.

Verified Compliance: Breezy Cloud™ tracks usage, treatment data, and generates audit-ready reports.

References

1. Gidey, K., et al. “Clinical and economic burden of healthcare-associated infections: A prospective cohort study.” PLoS ONE, 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC9949640/

2. Truitt, C. L., et al. “Evaluation of an aerosolized hydrogen peroxide disinfection system.” AJIC, 2021. https://doi.org/10.1016/j.ajic.2021.11.021

3. The Leapfrog Group. Hospital Safety Grade methodology. https://www.hospitalsafetygrade.org/

4. U.S. News & World Report. Best Hospitals methodology. https://health.usnews.com/health-care/best-hospitals/articles/faq-how-and-why-we-rank-and-rate-hospitals

5. CMS Hospital-Acquired Condition Reduction Program. https://www.cms.gov/medicare/quality/value-based-programs/hospital-acquired-conditions

6. CDC National Healthcare Safety Network (NHSN). https://www.cdc.gov/nhsn/index.html

7. Amodio, E.., et al. “Disinfecting noncritical medical equipment with aerosolized hydrogen peroxide.” AJIC, 2020. https://pubmed.ncbi.nlm.nih.gov/32464292/

8. Otter, J. A., et al. “An overview of automated room disinfection systems.” J Hosp Infect, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7152068/

9. Alnimr, A., et al. “Environmental Deposition of SARS-CoV-2: Role of Aerosolized Hydrogen Peroxide.” Risk Management and Healthcare Policy, 2021. https://doi.org/10.2147/RMHP.S336085

10. Triggiano, F., et al. “No-Touch Automated Disinfection System Based on Hydrogen Peroxide and Ethyl Alcohol Aerosols for Use in Healthcare Environments.” International Journal of Environmental Research and Public Health, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9029184/