Tackling healthcare infections outside of hospitals

Improvement Foundation Learning Workshop 1
held at South Birmingham

7th July 2009


West Midlands Strategic Health Authority commissioned the Improvement Foundation to engage in the Tackling Healthcare Infections in the Community Programme. The programme is aimed at ten care homes in the South Birmingham area. Derek Butler was pleased to be able to attend the first workshop to present "A Healthcare Infection, A Lifetime Legacy"


Introduction & Background

Dr Tim Dukes, GP & Clinical Adviser Improvement Foundation outlined the aim of the programme, which was to reduce healthcare associated infections acquired in the community- specifically in care homes. Teams from the PCT and Improvement Foundation will work with frontline staff and service users to deliver improvement that is rapid, systematic and sustainable.  This links in with the work done in hospitals and the commitment to reducing healthcare infections in the 2008/09 NHS Operating Framework. The programme supports and provides:

-       clear aims

-       framework of practical ideas

-       series of learning workshops

-       action periods in between

     protected time

-       focus on measurement

-       practical support

-      use of tried and tested improvement method


There are six change principles designed to drive improvement:


  1. 1. Adopt a multi-agency approach to ensure effective coordination of nursing and personal care to prevent and control healthcare associated infections.

 2.  Develop a culture of people and carer involvement.


  1. 3.  Ensure the safe and appropriate prescribing and use of antibiotics in the care home setting.

4.  Create a culture of reliable hand hygiene.


  1. 5.  Use data to drive improvement.

  1. 6.  Promote a safe and clean environment to reduce the risk of HCAI.

Change principles will secure the greatest improvement if implemented by all concerned.


The learning workshops give the opportunity to

-      hear from experts about healthcare associated infections

-      learn about improvement methods

-      share successes and failures

-      use measures to monitor progress


Action periods in between workshops will involve the use of the improvement model to:-

-       plan

-       develop and

-       implement change


The model for improvement asks:

-       what are we trying to accomplish?

-      how will we know that a change is an improvement?

-      what change can we make that will result in improvement?


Measurement for improvement is necessary to know where you are and where you're going.


Monthly measures will include:

-       number of admissions to hospital from a care home accompanied by the management plan

-       number of discharges from hospital to a care home accompanied by the discharge summary

-      total antibiotics prescribed items (collated by PCTs)

-      number of antibiotic cases for the care home residents

-      number of current care home staff who have been trained in HCAI preventive hygiene techniques

-      number of HCAIs acquired in the community ? Hospital data (collated by PCTs)

-     number of HCAIs acquired in hospital - Hospital data (collated by PCTs)


The event included speakers from across the local and national healthcare economy, discussing the following topics:


West Midlands SHA Overview - Kay Roberts

Clostridium Difficile - The Scale of the Problem in the UK - Dr Bharat Patel

The Role of the PCT in Supporting Care Homes -
Jane Lockwood


Improvement Methodology (Task/ PDSAs) - Chas Ryan


Breakout sessions included:


Healthcare associated infections:
Theories, Enigmas and Practical Approaches to

Good Practice Dr Bharat Patel


A Healthcare Infection - A Lifetime Legacy

Derek Butler


Hand Decontamination - Actions & Accountabilities

Pauline Bradshaw

If you or someone you care about has been affected by a healthcare infection and you wish to discuss this with us, please contact us at info@mrsaactionuk.net