Driving the HCAI agenda, Widening the net

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Driving the HCAI agenda,Widening the net

• Gaynor Evans

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Health economy approach

• Changing the focus from acute trust surveillance
  to a healthcare provider approach
• The dual role of PCTs (commissioner/provider)
• Defining community HCAI and identifying the
  impact on non NHS healthcare facilities
• Establishing multi organisational networks to
  address the burden of HCAI
• Embedding the responsibility for reducing HCAI
  within the culture of all healthcare providers
• Coordinating action across defined population
  areas by implementing joint responsibility action
  plans

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Interface between healthcare providers

• Acute trusts
• PCTs
• Mental Health trusts
• Ambulance trusts
• Private hospitals
• Learning disability units
• Laboratories
• Local Authorities (Including Social services)

• Care homes
• Hospices
• Voluntary services
• CSCI
• StHA
• HCC
• DH
• Improvement teams

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Setting rules of engagement

• Clear organisational roles and responsibilities
• Formal agreement of accountability
• Clear reporting mechanism for compliance with
  governance in health economy

HPA

SHA
Stakeholders
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Reducing HCAI- Targeted strategies

• Leadership responsibility/ accountability
• Communication developing public health
  information
• Surveillance addressing the gaps
• Training and developing skilled workforce.
• Research
• Improving joint actions with RMN (inc
  antimicrobial prescribing)
• Commissioning
• Governance

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Challenges to success

• Accountability
• Resistance to change
• Organisational change
• Personal ownership at all levels of the
  organisation
• Protected time training
• Governance

Poor leadership
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Challenges to success

• work with health economy to develop robust and
  timely communication mechanisms.
• In collaboration with StHA to implement lessons
• learned from the outcomes of RCAs across the WM
• work with PCTs to improve commissioning post
  discharge info for GPs and patients
• work with other organisations to create robust
  interagency networks

Communication
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Challenges to success

• What target? Finance, AE waiting, surgical
  waiting versus HCAI
• Are the targets sustainable long term?
• Performance targets- are they unreasonable or a
  way to focus action?

Competing Targets
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Challenges to success

• Human
• Financial
• Skills deficit -workforce development
• Training and education
• Poor / lack of facilities

Resources
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Challenges to success

• Contemporaneous data
• Communication with labs
• Interpretation and analysis
• Meeting the needs of stakeholders
• Is it reflecting a health economy perspective?
• Is appropriate skill mix reflected in modern
  infection prevention and control

Gaps in Surveillance
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• If there is a choice between changing human
  behaviour and new technology, go with the new
  technology every time!
• Rob Weinstein MD.