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Health care  –  Set up a program

Implement

At this stage in the process, the hands on work begins to initiate or strengthen the core components of infection prevention and control. Interventions can be piloted to test their effectiveness and adjusted as needed. Later they can be scaled up or replicated in other settings.

Pilot interventions

No matter how much planning is done, it is difficult to know how well an implementation will go in real life. Unforeseen problems can arise and the needs or resources can rapidly change. The Model for Improvement developed by the Institute for Healthcare Improvement can help to ensure that interventions are aligned with the overall aims and objectives. The model starts with asking key questions about the work to be undertaken and proceeds through a Plan-Do-Study-Act cycle to test ideas. By piloting an intervention with the PDSA cycle, the committee can test the impact of theory put into practice and make adaptations as necessary.

PDSA cycle
Figure 1. Plan-Do-Study-Act cycle adapted from Institute for Healthcare Improvement 

Plan-Do-Study-Act: 

Plan – prepare an action plan for implementation

Do – trial the actions in a specific unit or area, or with a certain group of patients

Study – compare the baseline and progress measures

Act – take action depending on the results  – continue with the trial in one unit or spread your implementation plan to other areas

Scale up interventions

Pilot projects can be scaled up in time, size or breadth of their reach. The length of time can be extended, a project can be implemented in additional units or departments, or they can reach out to additional personal that were not targeted in the first approach. Challenges may arise when scaling up interventions that did not exist in the original iteration. As with any implementation, the context and setting should always be considered and adjustments made appropriately.

Interventions provides information and resources on basic, infection specific and pathogen specific interventions for infection prevention and control.

Resources for education and training of health care personnel can be found in RAISE AWARENESS – Education and training.

Selected Resources

Resource Description
Improving infection prevention and control at the health facility: interim practical manual supporting implementation of the WHO guidelines on core components of infection prevention and control programmes Manual to support effective implementation of IPC programs in health facilities, in line with the WHO Core components for infection prevention and control programmes. Provides practical guidance, tips, tools and examples.
Guidelines for the Prevention and Containment of Antimicrobial Resistance in South African Hospitals Example guidelines to implement antibiotic stewardship and infection prevention for hospitals. Intended for health care professionals in their day-to-day management of resistance. The guidelines build on international guidances and interventions that have been shown to be successful. Customized for South African hospitals based on local experiences. To be used together with Guidelines on Implementation of the Antimicrobial Strategy in South Africa that provides guidance on governance.
How to Improve, Institute for Healthcare Improvement Improvement model used very successfully by hundreds of health care organizations in many countries to improve many different health care processes and outcomes.
Nine steps for developing a scaling-up strategy Guide that facilitate systematic planning for scaling up.
1.
World Health Organization. Improving infection prevention and control at the health facility: Interim practical manual supporting implementation of the WHO Guidelines on Core Components of Infection Prevention and Control Programmes. [Internet]. WHO. 2018 [cited 2018 Aug 8]. Available from: https://www.who.int/publications/i/item/WHO-HIS-SDS-2018.10
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Department of Health, Republic of South Africa. Guidelines for the Prevention and Containment of Antimicrobial Resistance in South African Hospitals [Internet]. 2018. Available from: https://www.knowledgehub.org.za/elibrary/guidelines-prevention-and-containment-antimicrobial-resistance-south-african-hospitals
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World Health Organization - WHO. Nine steps for developing a scaling-up strategy [Internet]. WHO. [cited 2014 Aug 19]. Available from: http://www.who.int/reproductivehealth/publications/strategic_approach/9789241500319/en/
1.
Institute for Healthcare improvement - IHI. Science of Improvement: How to Improve [Internet]. How to improve. 2014 [cited 2014 Aug 21]. Available from: http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementHowtoImprove.aspx