Infection control key performance indicators selection and establishment

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Infection control key performance indicators selection and establishment

  1. 1. Rania Mohamed El-Sharkawy rania.elsharkawy@alex-mri.edu.eg Lecturer of clinical chemistry, MRIAlexandria University ,CPHQ,LSSGB Health governance –MRI-Alex university unit coordinator IHI Egypt & NAHQ member
  2. 2. Infection control indicators between monitoring and improvement
  3. 3. WHO recommendations ……… GENERAL CONCEPTS •Health care-associated infections lead to death, disability and excess medical costs. •Infection prevention and control program will reduce the cost if applied and monitored effectively
  4. 4. WHO recommendations ……… GENERAL CONCEPTS Health-care facilities must implement infection prevention and control policies supported by institutional management.
  5. 5. WHO recommendations ……… GENERAL CONCEPTS • Infection prevention and control maximize patient outcomes and is part of the institute's responsibility to provide effective, efficient and quality health services
  6. 6. WHO recommendations ……… Approach An overall approach to an infection prevention and control policy at the health-care facility level is based upon Management Communication and education Indicators & Audits
  7. 7. KPI = Key Performance Indicator
  8. 8. Objectives How to select and implement indicators + = • awareness of maintenance performance. How to use indicators for improvement
  9. 9. Determine………
  10. 10. What are indicators? KPIs are quantifiable measurements that reflects the critical success factors of a business. KPIs have a major impact on the performance of the business KPIs are quantitative measures of a specific part of a process or of an outcome.
  11. 11. What is a KPI? KPIs track performance against established goals. •Key Performance Indicators (KPI) are related to goals or objectives and provide a means for tracking performance against that goal or objective. •KPI are used to assess current performance (LAG) and guide action toward improvement and enhancement (LEAD) Predict LEAD Current LAG
  12. 12. Why indicators? Tool for performance monitoring • Track changes over time Identify areas that need further study and investigation
  13. 13. Choice of indicators Step 1: Define Organization`s Strategy Step 2: Audit Existing Measures Step 3: Develop Measures Step 4: Educate and train Step 5:Analyza and report
  14. 14. Determine… How to determine the indicator ?  Process flow chart  Observation of process  Process outcome
  15. 15. KPIs should be? Surgical VS Prosthetic 1-Related to quality dimension/s(efficiency, efficacy, appropriateness, availability, timelines, effectiveness, continuity )
  16. 16. KPIs should be? 2- Specific 3-Measurable 4-Aligned 5-Timely 6-Realistic 7-Ethical 8-Recorded
  17. 17. KPIs are not………… WHAT ARE KPI’s NOT? 1-GROUP OF METRICS • NOT EVERYTHING WE MEASURE IS A KPI ! 2- STATISTICS •THESE CAN HELP DEFINE KPI’s 3- A TOOL FOR BLAME 4- WALL PAPER
  18. 18. Types of indicators • Efficiency of PROCESS • Outcome ( effectiveness) •Monitoring &measurement of Processes
  19. 19. KPIs are tools for collection of data Types of indicator  Sentinel-event  Aggregate data
  20. 20. KPIs are tools for collection of data  ContinuousAggregate data variable  Rate –based
  21. 21. KPIs are tools for collection of data Types of indicator  Sentinel-event e.g Intrahospital mortality of patients due to infections within two post procedure days (MMR)
  22. 22. KPIs are tools for collection of data Aggregate data  Continuous-variable e.g No of complains or incidents monthly raised / department
  23. 23. KPIs are tools for collection of data Aggregate data  Rate –based e.g Proportion of staff observed performing hand hygiene before attending patients
  24. 24. Improvement… How to use it for improvement ?  HOW TO DETERMINE THE desired performance ?
  25. 25. HOW TO DETERMINE THE desired performance ?  Compare against benchmark  Refer to guidelines  Compare self performance versus same circumstances in the same period
  26. 26. Core infection prevention and control interventions for health-care facilities process Indicator Hand hygiene Proportion of staff observed performing hand hygiene before attending patients Proportion of staff observed wearing gloves when exposure to blood or body fluids is anticipated Average time between admission and isolation for tuberculosis patients Proportion of intravenous lines inserted using aseptic technique Proportion of rooms appropriately disinfected after patients' discharge Proportion of sterilized devices whose sterility is documented with test strips Three-dose hepatitis B vaccine coverage among nurses, physicians and laboratory technicians Personal protective equipment Isolation precautions Aseptic technique Cleaning and disinfection Sterilization Immunization and exposure management
  27. 27. Hand washing process indicator
  28. 28. HAND WASHING KPI Effectiveness % of hand washing frequency = Number of times employees did wash their hands / Number of times employees should have washed their hands)
  29. 29. HAND WASHING KPI Outcome efficiency % In-compliance= Number of times employees did wash hands with method in guidelines / Number of times employees should have washed their hands
  30. 30. Compare self performance versus same circumstances in the same period
  31. 31. Performance over time
  32. 32. Chart showing trend
  33. 33. Self-Reported Factors for Poor Adherence with Hand Hygiene Hand washing agents cause irritation and dryness Sinks are inconveniently located/lack of sinks Lack of soap and paper towels Too busy/insufficient time Understaffing/overcrowding Patient needs take priority
  34. 34. Corrective actions for improper compliance 1. Have a clear written policy and procedure 2. Educate personnel continuously 3. Easy access to hand washing facilities
  35. 35. Provide an environment that supports hand washing - NOT Like THIS……………………………………..LIKE THIS Bad hand washing facility Encouraging hand washing facility
  36. 36. Corrective actions for improper compliance 4. Careful selection of products 5.Monitor the technique and provide indicators 6. Record and analyze the results to improve the compliance
  37. 37. Cleaning and disinfection KPI………
  38. 38. Cleaning and disinfection KPI Effectiveness (rate based indicator) Proportion of rooms appropriately disinfected after patients' discharge(WHO indicator)
  39. 39. Cleaning and disinfection KPI Efficiency No of facilities reaching the desired total number of acceptable limit / facilities
  40. 40. For improvement In any organization… It is better to have………………….
  41. 41. HAND WASHING KPI
  42. 42. Dashboard for indicators……….
  43. 43. DASHBORD MODEL
  44. 44. DASHBOARD MODEL
  45. 45. Other Tips for Good KPIs REMEMBER…….
  46. 46. 1. Have them! 2. Align them to mission, vision, strategy 3. Test them for validity and reliability, practicability 4. Discuss them and review them. Are they really key? Don’t overestimate their importance! 5. Differentiate between lag and lead indicators (determine the type)
  47. 47. 6. Benchmark them 7. KPI should lead to change 8. Use them for Improvement

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