Further Winning Ways the National DIPC Development Programme

1
Further Winning Ways- the National DIPC
Development Programme

• Professor Brian Duerden
• Inspector of Microbiology and Infection Control,
• Department of Health, London

2
Responsibility for HCAI

• Clinicians
• Safe patient care
• Diagnosis
• Treatment
• Prevention
• Control
• DIPC/CEx/Board
• Corporate environment
• Make it happen

• Government/DH
• Set standards
• Ensure priority
• Monitor outcome
• Legislation
• Performance management

3
Reducing HCAI.

• Change the mindset
• From
• 1) create a system to deliver specialist clinical
  care
• 2) take measures to prevent infection
• To
• 1) create a safe environment for patient care
• 2) deliver specialist clinical care within that
  environment

4
How do we change bad habits?

• Enhanced surveillance (HPA)
• Clinical practice protocols
• Cleanliness and hygiene
• hand hygiene environmental cleaning
• Training
• Management
• emphasis on infection control
• pivotal role of DIPC

5
..and now legislation

• Health Act 2006
• Statutory Code of Practice
• 11 core duties
• Compliance assessed by the Healthcare Commission

6
WW Action area 6.Management and organisation

• Chief Executives responsibilities
• Core part of Clinical Governance and Patient
  Safety programmes
• Promote low levels of HCAI
• Ensure actions are taken
• Aware of legal responsibilities to identify,
  assess and control risks of infection
• Appoint Director of Infection Prevention and
  Control

7
Director of Infection Prevention and Control

• Oversee CoI policies and implementation
• Responsible for ICT
• Report directly to CE and board
• Challenge inappropriate hygiene practice and
  antibiotic prescribing
• Assess impact of plans/policies on IC
• Member of Clinical Governance and Patient Safety
  teams/structures
• Produce an annual report

8
Further guidance competencies

• Extension of existing person
• Professionally qualified
• Expertise experience
• IC, infected patients, decontamination,
  antibiotic usage
• Competencies
• Strategy, leadership, planning delivery,
  resource management, change people management,
  delivery, corporacy, holding to account

9
DIPC role

• Senior management Board/CEx report
• Professional credibility
• Special expertise
• Reporting line for ICT
• Policy implementation
• Performance management
• Resource allocation
• A champion a manager!!

10
The story so far.

• Appointed in all NHS bodies
• Range of professional backgrounds
• Medical Director Director of Nursing Medical
  Microbiologist Consultant ICN DPH
• Reporting line
• Board member (executive officer)
• Report directly to Board and Chief Exec.
• Report through another Exec. Board member

11
Effectiveness?

• High impact on all Trust activities
• Called in for specific IPC topics
• Distant and small impact
• Supportive of ICT and IPC programme
• Obstructive/buffer between ICT and
  Executive/Board

12
Questions

• Person
• Professional and Management credibility
• Reporting Board/Chief Exec/Non-Exec
• ICTeam and ICCommittee relationship
• Policy implementation
• Performance management
• Resource allocation

13
Person

• Professional background
• Credibility expertise/experience in IPC
• Challenge other professionals practice
• Performance management of clinical directorates
• Individual performance review of clinicians
• Job descriptions objectives
• Authority with non-clinical executives

14
Reporting line

• Direct to Chief Exec. and Board
• Board member?
• if not
• Attendance frequency
• Input to other discussions with IPC perspective
• Relationship to non-exec. Board members

15
IPC relationship

• IC Committee Chair?
• Reporting line
• Clinical governance Risk management Patient
  safety
• IC Team
• Member? Manager? Appraiser? Champion?

16
IPC policies

• Initiation
• Development
• Approval
• Implementation
• Monitoring and audit

17
Performance management

• Infection control team
• Clinical directorates
• Individual clinicians
• Medical, nursing
• Appraisal
• Objectives
• CPD

18
Resource allocation

• Resources for IPC
• Budget holder?
• Promote bids?
• Influence on other budgets
• Influence on developments
• New services
• Estates and facilities
• Refurbishment new build

19
DIPC..

• Authority
• Accountability
• Responsibility
• ..and a champion for IPC