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Health care  –  Set up a program

Evaluate progress

The monitoring and evaluation provides insight into impact of the program. It helps to see if goals are being accomplished and can identify aspects that may need improvement which is important in the scale-up, and replication of interventions.

Outputs from evaluation can be used for evaluating interventions, revising national or local guidelines, or presenting facts for underlying policy decisions. Benchmarking between departments or health care facilities can be used to encourage improvement as no one wants to be seen as the worst. However it is important to encourage improvement and promote learning from experience without fear of negative consequences.

Develop a monitoring and evaluation framework

Often evaluation is done by measuring indicators, however in addition, the collection of descriptive data can be helpful to give a comprehensive view of the extent to which changes are occurring. When developing a monitoring and evaluation framework, teams should consider:

  • What will be measured?
  • How data will be collected and recorded
  • Analysis and interpretation of data
  • Feedback of the results to all stakeholders
  • Acting on the results

Measurement and indicators

Both process and outcome measures should be used within the monitoring and evaluation framework. The two types of indicators give different perspectives on the success of infection prevention and control programs.

Process indicators

Process measures give a view if improvements have been made in infection prevention and control practices and techniques. Some examples are:

  • % of staff members who are vaccinated
  • % of patients who are screened for infection control risk
  • % of staff who attended a training

Outcome indicators

Outcome measures inform if the infection prevention and control programs or interventions have improved the infection situation. Some examples are:

  • % improvement of staff following hand hygiene guidelines
  • % change in antibiotic consumption
  • % reduction in duration of hospitalization
  • % reduction in resistance rates
  • % reduction in health care-associated infections
  • Incidence of Clostridium difficile infections

In MEASURE you can find tools and resources for measuring various aspects of antibiotic resistance, such as incidence of infections, quantity of antibiotic use and knowledge, attitudes, behaviors and perceptions.

Analyze results

Data collected should be analyzed by the committee and additional key stakeholders. Involving people from outside the committee can provide additional understanding of what is happening in a particular setting and helps to build ownership of finding solutions. When reviewing results, dialog and discussion can help to understand the meaning of the results. Interventions showing progress can be considered for scaling up. However when there is no indication of change or improvement, committees should discuss possible explanations and decide if changes need to be made to the program.

Communicate results and provide feedback

Results should be fed back to collaborating partners and interested stakeholders, especially management. Communication methods and content should be tailored to the audience. Positive progress should be acknowledged and public recognition should be made of the contributions and successes of all partners involved in the project. Affirmation of hard work will provide incentive for staff to continually improve and be involved in the process:

Selected Resources

Resource Description
IFIC Basic Concepts of Infection Control Manual that provides a scientific foundation for basic infection control principles mainly to countries with limited resources. The 2016 Edition available in English. The 2011 Edition is available in Spanish, Italian, French, Hungarian, Arabic and Bulgarian. Several chapters may be useful including:

Chapter 6: Audits in Infection Prevention and Control

Clean Care is Safer Care: Tools for evaluation and feedback Tools and resources from WHO for evaluation and feedback on hand hygiene interventions, including:

  • Perception Survey for Health-Care Workers
  • Perception Survey for Senior Managers
  • Data Entry Analysis Tools
The Community Toolbox This tool, will help plan for good, consistent, clear, communications both internally and externally. Chapter 6, Section 1 gives information on how to develop a communication plan.

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