'Winning ways' sharing strategies for high performing hygiene services

摘要

Cleanliness countsudEnsuring a clean environment is fundamental to the provision of safe and high quality care. The hospital environment is one of the first things which patients and their families experience when they seek care and ensuring this is clean gets the first impression right. Importantly, some aspects of hygiene services support the prevention and control of healthcare infection. Healthcare infection is a concern for those receive and provide care alike and, while recent downwards trends in MRSA-related bloodstream infection are encouraging, there is no room for complacency.udLessons learnedudTwo key lessons emerged from HIQA’s hygiene service reviews in 2007 and 2008. Firstly, hospitals operated or funded by the HSE are making improvement; fundamentals are in place with services on the ground performing well and hospitals are now developing the corporate management to sustain performance and ensure continuous improvement. Secondly, however, against a background of overall improvement, a wide spread of performance emerged: a few hospitals are exemplary, most are making reasonable and steady improvement, however, some struggle to keep up with the pace of progress.udIn response to these reviews, in 2009 the NHO at the HSE has applied a “targeted intervention” to hospitals which it identified as making slower progress with the improvement of hygiene services. The principles underpinning this intervention are accountability and sharing of learning across peers.udAccountability and sharing learningudAccountability in healthcare is a complex and multifaceted concept. It is important that there is accountability for good performance as well as poor performance. How else can we acknowledge what is done well and learn from it to drive further performance? Sharing of learning from peers is recognized as a strategy for improving performance of teams and organizations. In the case of hygiene service, it was evident to the NHO that the expertise to drive high performance already exists within the system; the challenge is to unlock this expertise and share it widely across hospitals.ud“Winning ways”udEarly in 2009, the NHO contacted hospitals identified as having high performing hygiene services based on their results in HIQA’s reviews in 2007 and 2008. Hospital managers/CEOs and their hygiene service teams were asked to provide the NHO with examples of strategies which they use to drive high performance and continuous improvement. These tips on winning ways were collated by the NHO. The main themes were as follows:ududMake hygiene services a priority through leadershipududMake roles, responsibilities and reporting relationships clearududSet the right direction and align effortsududLink with prevention and control of healthcare associated infectionududGet service users involvedududGet staff involvedududKeep external contractors in close checkududUse information to monitor and evaluate performance and provide feedbackudThis document presents these strategies with examples of implementation so as to share them and to spread good practice across all hospitals.