Infection Control, Quality Improvement and Improving Use of Medicine

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Infection Control, Quality Improvement and
Improving Use of Medicine
Regina Berba MD Philippine Quality
Improvement-Infection Control (QI-IC) Study Group
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Infection Control (IC) Practice in the
Philippines

• gaining increasing acceptability
• criteria for accreditation and standards for IC
  still being developed
• limited resources

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Usual Scope of IC Programs
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Infection Control Quality Improvement

• QI and IC a SYNERGISTIC relationship
• infection control is an ideal model for QI
  efforts
• proven efficacy in reducing the occurrence of
  infections that compromise patient outcomes and
  increase costs
• the marriage of infection control epidemiology
  with quality improvement is a logical step to
  support the development of a robust discipline
  that combines the best of both worlds.

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Variation in Infection Control Practice
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An MSH Rational PharmaceuticalManagement Plus
Project
Sponsored by the US Agency for International
Development
Mission of the hospital IC component Decrease
hospital-acquired infections, especially those
caused by antimicrobial resistant bacteria, in
resource-limited countries
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Improving Infection Control Practices in the
Philippines through a Multi-center Collaborative
Evidence-Based Quality Improvement Program

• This collaborative project specifically aims to
  test effectiveness of the quality improvement
  (QI) model as a strategy in improving the
  implementation of priority IC practices

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Quality Improvement in Infection Control (QI-IC)
Study Team

• USAID
• MSH RPM Plus
• Harvard Medical School
• Boston University

• University of the Philippines
• Participating Hospitals
• Cagayan Valley Medical Center
• National Kidney and Transplant Institute
• The Medical City
• University of the East Ramon Magsaysay Memorial
  Medical Ctr
• University of the Philippines -- Philippine
  General Hospital

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Methods
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July 2002Workshop 1
6 months
January 2003 Workshop 2
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(No Transcript)
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Model for Improvement
Define the goal
Analyze the system
Rapid-cycle small scale tests of changes in
the system
Langley GJ, Nolan KM, Nolan TW. The foundation
of improvement. API Publishing, 1992.
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Results
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Lessons Learned

• Well motivated infection control teams
• Flexible team of facilitators
• Evidence-based QI interventions
• Co-ownership of projects with end-users/hospital
  staff
• Use of QI strategy and tools

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Challenges

• Sustainability
• Institutionalization
• Replicability of QI Projects in other ICUs and
  special areas Neonatal ICU, Burn Unit
• Application of QI in other fields other than IC
  TB DOTS centers
• Economics of QI interventions