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The Scottish Patient Safety Programme. HAI – Leadership in Infection Prevention and Control NHS GG&C. Three Key Leadership Elements in Infection Prevention and Control. Directorate accountability Performance management Surveillance and Clinical incident reporting.

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the scottish patient safety programme

The Scottish Patient Safety Programme

HAI – Leadership in Infection Prevention and Control NHS GG&C

three key leadership elements in infection prevention and control
Three Key Leadership Elements in Infection Prevention and Control
  • Directorate accountability
  • Performance management
  • Surveillance and Clinical incident reporting
what are our underlying leadership principles within the infection control service
What are our underlying leadership principles within the Infection Control Service ?
  • Patient focused
  • Data driven
  • Evidence based (and prepared to formulate evidence where none exists)
  • Closely linked into Management and Clinical Governance structures
  • Responsive to targets
sab heat target
SAB HEAT Target

Target: 15% reduction by March 2011

GG&C Aim: 20% reduction by March 2011

Issue: How do we develop a system to manage this?

sabs project plan
SABs Project Plan

Develop Reporting Structure

Develop a formal sub-group of AICC

Develop local action groups with rolling action plans

Utilise Our Infection Control Staffing Resource

Existing project team (MRSA Screening) tasked with facilitation of groups

Utilise Our Data (Using Improvement Methodology)

Target interventions in areas of highest prevalence

Monitor progress towards target

Review surveillance of SABs

Promote Local Ownership

By identifying areas specific to directorates, interventions will be targeted, appropriate and locally owned

Ensure an Inclusive Approach

Consideration will be given to work already being progressed by SPSP, practice development and directorates.

utilise infection control staff resource
Utilise Infection Control Staff Resource

MRSA Screening Project Team:

  • Utilised as there was a gap in policy decision for screening.
  • Project Nurses were already aligned to directorates.
  • Provided a formal reporting and monitoring structure.
  • Were responsible for hosting local action group meetings (meetings chaired by directorate Head of Nursing)
  • Facilitation by Project Team: Rolling action plans, research etc.

Infection Control Leads:

  • Lead Nurses provided expertise to local groups
  • Lead Surveillance Nurse coordinated data
  • Consultant Microbiologist, Assistant Head of Nursing and Infection Control Manager visibly supported process.
utilising our data
Utilising our Data

Pareto charts focused our attention:

At Board Level

At Directorate Level

Trajectories reminded us of the goal:

The GG&C Target

The Directorate Target

Ad hoc reports:

Were produced on directorate request. E.g. HAI only, source of SAB.

key workstreams infection control
Key Workstreams – Infection Control

Enhanced SAB Surveillance

Leads ICNs and Lead Surveillance Nurse reviewed current documentation and database. An enhanced form was launched in July 2010.

Enhanced Reporting

In addition to directorate reports, all directorates will now be receiving an enhanced summary of the above SAB surveillance.

key work streams emergency care and medical services
Key Work streams – Emergency Care and Medical Services

Blood Cultures: Developing NHS GG&C Blood Culture Policy

Evidence based approach

Blood Culture contamination audit

PVCs: Production of poster ‘Pause. Think….’

Surveillance snapshot of PVC use (approx 30% unused in first 24 hours).

observations so far
Observations so far….

Benefits noted:

  • Joint working
  • Shared ownership of target
  • Project management facilitation is helping push actions
  • Evidence based approach is helping to engage clinicians – they are leading the direction of travel.
observations so far 2
Observations so far….(2)

Areas of uncertainty:

Unable to link SABs rate with SPSP ward performance/scores

SPSP is not mandated to deliver HEAT targets

SPSP rollout is not correlated with areas of high HAI prevalence

SPSP is focused on process and relies on reliability to drive outcomes which are not measured.

creating a combined approach
Creating a Combined Approach

SOLUTION: Needs to be combined process linked to board governance based on performance indicators from multiple areas.

Continuous Improvement

Targeted Improvement

slide21

Thank you

Any Questions?