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Health care  –  Set up a program

Plan an intervention

The multi-stakeholder committee should plan how to implement the core components of infection prevention and control and determine which interventions to use in the process to form a sustainable effort.

A variety of tools and strategies can be used. Whichever methods are chosen, they should be based on local data, be routed in existing cultural structures of health care facilities, and tailored to the specific setting depending on factors such as size, complexity, and resources available.

Develop aims and objectives

Setting aims and objectives will help the committee know where to focus its energy and how to direct its resources. Consider what you want to achieve, and what change can be made that will result in an improvement. When developing objectives it is important to make them SMART.

  • Specific
  • Measureable
  • Achievable
  • Results Oriented
  • Time Limited

Consider tools and strategies

Interventions should be built upon a combination of tools and/or strategies. Tools include checklists, audit tools, bundles and educational tools. Some commonly reported implementation strategies are:

  • Educational outreach visits
  • Interactive educational meetings
  • Printed educational materials
  • Influence through local opinion leaders or champions
  • Interprofessional or multidisciplinary collaboration
  • Audit and feedback

Choose strategies

With many different options, it can be difficult to decide on which strategies will work best. Important questions to consider are: :

  • Is there evidence to support the use of the strategy?
  • Has the strategy been used in a similar context?
  • How might the strategy need adaptation to this setting?
  • Are sufficient resources available?
  • Is approval required for implementation?
  • What type of training will be needed?
  • What issues does this strategy uniquely address?
  • How will this strategy help overcome identified barriers?

Develop an implementation plan

A good implementation plan will cover the steps in the process, what actions are needed to be taken, by who and when, as well as what resources are needed and how to measure progress. The implementation plan can include:

  • Communication plan – How will the plans be communicated to those directly and indirectly involved with the process?
  • Risk assessment – What are the inherent risks that might occur with implementation?
  • Monitoring and evaluation framework – For monitoring of progress of the program

Selected Resources

Resource Description
Infection Prevention A reference booklet for health care providers Quick desk reference for infection prevention and control in resource limited settings. Available in English and French (Earlier version in Spanish). Step-by-step instructions for how to perform critical procedures.
The ISID Guide to Infection Control in the Healthcare setting Guide that summarizes principles, interventions, and strategies to reduce healthcare associated infections. Contains more than 60 short chapters on a variety of topics including antibiotic resistance. See for example chapters on

The guide is also available in Spanish.

The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement The Institute for Healthcare Improvement works to improve quality and value of health care by supporting change. The Breakthrough Series is designed to help organizations create a structure where they can learn from each other and experts in areas where they want to improve.
WHO Multi-professional Patient Safety Curriculum Guide Guide aimed at health care educators and students. It contains ready-to-teach, patient safety programmes that can be used as a whole or on a per topic basis. Topic 7 in part B: Using quality-improvement methods to improve care focuses on how to improve the quality and safety of health care in a systematic way and the basic methods to measure improvement in patient safety (teaching slides can be found here). Available in Chinese, Czech, English, French, Indonesian, Italian, Japanese, Polish, Spanish.
Toolkit: Implementation of Best Practice Guidelines, Second Edition Toolkit that assists health care settings in maximizing the potential of clinical practice guidelines, through systematic and well-planned implementation, developed by the Registered Nurses’ Association of Ontario, Canada.
Enhancing Project Spread and Sustainability, NSW Clinical Excellence Commission Guide (PDF) Guide that provides advice to clinicians and health managers on how to improve and assess the spread and sustainability of clinical practice improvement projects in a systematic way.
NHS Guide to Sustainability Guide that provides practical advice on how you might increase the likelihood of sustainability for your improvement initiative. See also Sustainability model and guide.
Workload Indicators of Staffing Need (WISN) Tool: A human resource management tool for health managers. Provides a systematic way to make staffing decisions to manage valuable human resources well. Software with manual, available in English, French and Spanish.

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International Society for Infectious Diseases - ISID. The ISID Guide to Infection Control in the Healthcare setting [Internet]. ISID - International Society for Infectious Diseases. [cited 2019 Jul 5]. Available from: https://www.isid.org/education/guide-to-infection-control-in-the-healthcare-setting/
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National Health System: Institute for Innovation and Improvement. Sustainability Guide [Internet]. National Health System; 2009 [cited 2014 Aug 21]. Available from: https://www.england.nhs.uk/improvement-hub/publication/sustainability-guide/
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World Health Organization - WHO. Workload Indicators of Staffing Need (WISN) [Internet]. WHO. 2015 [cited 2017 Oct 26]. Available from: http://www.who.int/hrh/resources/wisn_user_manual/en/
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World Health Organization - WHO. Patient Safety Curriculum Guide Multi-professional Edition [Internet]. World Health Organization; 2011 [cited 2014 Aug 19]. Available from: http://www.who.int/patientsafety/education/mp_curriculum_guide/en/
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World Health Organization - WHO. Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level [Internet]. WHO. 2016 [cited 2017 Feb 17]. Available from: http://www.who.int/infection-prevention/publications/ipc-components-guidelines/en/
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RNAO - Registered Nurses of Ontario. Toolkit: Implementation of clinical practice guidelines, 2nd edition [Internet]. RNAO - Registered Nurses of Ontario; 2012 [cited 2016 Jun 23]. Available from: http://rnao.ca/bpg/resources/toolkit-implementation-best-practice-guidelines-second-edition
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Australian Commission on Safety and Quality in Healthcare. The OSSIE toolkit for the implementation of the Australian guidelines for the prevention of Infection in Health Care 2010 [Internet]. Commonwealth of Australia; 2010 [cited 2014 Aug 21]. Available from: http://www.safetyandquality.gov.au/publications/the-ossie-toolkit-for-the-implementation-of-the-australian-guidelines-for-the-prevention-of-infection-in-health-care-2010/
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Clinical Excellence Commission - CEC. Enhancing Project Spread and Sustainability: A companion to the “Easy Guide to Clinical Practice Improvement” [Internet]. 2008 [cited 2014 Aug 21]. Available from: http://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0007/258343/spread-and-sustainability.pdf
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Charani E, Holmes AH. Antimicrobial stewardship programmes: the need for wider engagement. BMJ Qual Saf [Internet]. 2013 Nov;22(11):885–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/?term=Antimicrobial+stewardship+programmes%3A+the+need+for+wider+engagement
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Engender Health. Infection prevention: a reference booklet for health care providers [Internet]. Engender Health; 2001. Available from: http://www.medbox.org/preview/52951e25-3818-4af1-880c-309f1fcc7b89/doc.pdf
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IHI Innovation Series white paper. The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. [Internet]. Institute for Healthcare Improvement; 2003. Available from: http://www.ihi.org/resources/Pages/IHIWhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforAchievingBreakthroughImprovement.aspx