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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 AWARENSS – Health care.

Selected Resources

Resource Description
How to Improve, Institute for Healthcare Improvement This model is used very successfully by hundreds of health care organizations in many countries to improve many different health care processes and outcomes.
The OSSIE Toolkit for the implementation of The Australian Guidelines for the Prevention of Infection in Health Care 2010 Practical tools, resources and information that can be used in a range of health care settings to help implement guidelines for the prevention and control of infection.
ExpandNet-Who Nine Step Guide published, WHO The aim of this guide is to facilitate systematic planning for scaling up.