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 and Control Course Series | Information portal linking to a number of self-paced and free courses developed by the WHO. Infection Prevention and Control (IPC) core components and multimodal strategies, takes about one hour to complete and provides guidance to development and implementation of IPC programmes in health care facilities. Also describes how IPC can decrease harm from health care-associated infections and antimicrobial resistance. |
| Resource considerations for investing in hand hygiene improvement in health care facilities | Manual to help estimate the investments needed to implement and sustain comprehensive hand hygiene programs in health care facilities at all levels, using the “multimodal improvement strategy” (MMIS) approach. Intended for policy-makers, senior facility managers, IPC leads and others involved in developing and implementing hand hygiene improvement programs. Presents inputs required and support tools to estimate investments needed; and support health workers to perform hand hygiene at the point of care. |
| 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 Community Toolbox | Toolkits. The Community Toolbox aims to offer people engaged in local and community work a depository of tools and advice for building healthier communities. See Chapter 6, Section 1 “Developing a plan for communication” that will help plan for good, consistent, clear, communications both internally and externally. |
| WHO Multi-professional Patient Safety Curriculum Guide | Guide aimed at health care educators and students with ready-to-teach, patient safety programmes. 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. Available in Chinese, Czech, English, French, Indonesian, Italian, Japanese, Polish, 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. |
| 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. |
| 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. |