The Strategic HAI Agenda. Dr R G Masterton Executive Medical Director

Transcription

1 The Strategic HAI Agenda Dr R G Masterton Executive Medical Director

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3 HAI as Big Business Overall prevalence of HAI in acute hospitals = 9.5% (8.8% 10.2% 95% CI). Urinary Tract Infections = 17.9% of all HAI, but only 1.9% of hospital population Surgical Site Infections = 15.9% of all HAI, but only 1.7% of hospital population Gastrointestinal Infections = 15.4% of all HAI, but only 1.6% of all hospital population NHS Scotland National HAI Prevalence Survey 2007

4 HAI as Big Business Overall prevalence of HAI in nonacute hospitals = 7.3% (6.0% 8.6% 95% CI). Urinary Tract Infections = 28.1% of all HAI, but only 2.1% of hospital population Skin and Soft Tissue Infection = 26.8% of all HAI, but only 2.0% of hospital population NHS Scotland National HAI Prevalence Survey 2007

5 HAI as Big Business Overall costs of HAI in Scotland estimated to be 183 million per year. Cost of HAI in individual specialties ranges 2 million per year in Obstetrics 2 million per year in Urology 49 million per year in Medicine). If a 30% reduction in HAI could be achieved an overall annual cost reduction of 55 million could be made in acute hospitals in Scotland. NHS Scotland National HAI Prevalence Survey 2007

6 What does the playing field look like? Govt. Public NES Inspection CSO Boards

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8 What does the playing field look like? Govt. Public NES Inspection CSO Boards

9 What does the playing field look like? Govt. Public NES Inspection CSO Boards

10 What does the playing field look like? Govt. Public NES Inspection CSO Boards

11 What does the playing field look like? Govt. Public NES Inspection CSO Boards

12 What does the playing field look like? Govt. Public NES Inspection CSO Boards

13 What does the playing field look like? Govt. Public NES Inspection CSO Boards

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16 The Agenda Perspective or which end of the telescope? Politicians Public Patient NHS Boards NHS Management Clinicians

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19 The Future is:

20 The Past: The HAI Task Force. First met in January 2003, in response to the Ministerial HAI Action Plan, Preventing Infections Acquired While Receiving Healthcare. Three year action plan. Phoenix-like organisation.

21 The HAITF Remit. Increase public confidence through demonstrating improvements in HAI prevention/control and cleaning, and ensuring public involvement in the development and implementation of the national HAI strategy. Develop policy and best practice for prevention and control. Act as a focal point for the exchange of information, experience and best practice between organisations. Develop robust monitoring and audit to measure compliance with SEHD requirements. Develop robust surveillance data and actions to address issues identified from surveillance. The provision of an annual progress report to the Scottish Government on the HAI national strategy.

22 The HAITF 2009/10. Delivery Plan. 5 streams of Work: Health Protection Scotland NHS Education for Scotland NHS Quality Improvement Scotland Scottish Microbiology Forum Scottish Medicines Consortium Health Facilities Scotland

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24 The Future HAITF is: The orchestra conductor HAITF and the service; Policy directorates in SGHD Stakeholders on the HAITF. Clear vision and horizon scanning function. Responsiveness e.g. burden of infection within the community. Comprehensiveness i.e. antimicrobial resistance, decontamination agenda, Advisory or decision making?

25 The Future is: More politics.. Public awareness and challenges Mutuality Continuous quality improvement Safety Inspections Accountability professional and legal Targets financial and others

26 The Future is:

27 What does Quality look like? People in Scotland have told us that they need and want the following things from the NHS. Caring and compassionate staff and services Clear communication and explanation about conditions and treatment Effective collaboration between clinicians, patients and others A clean and safe care environment Continuity of care and good access to care Clinical excellence

28 The Quality Focus is: Patient centeredness The safety of patients Clinical effectiveness

29 A Fresh Look at Effectiveness in HAI: Surgical Site Infections Central Venous Catheter Bacteraemia Ventilator Associated Pneumonia Catheter Urinary Tract Infections Clostridium difficile Infection Antimicrobial resistance

30 A Fresh Look at Effectiveness?: Southeastern Ontario, 2008

31 A Fresh Look at Effectiveness?: Intervention Southeastern Ontario, 2008

32 The cost of Ineffectiveness : Southeastern Ontario, 2008

33 The HAI Quality Target Healthcare Associated Infection Achievable Reduction Blood Stream Infection 18% 66% Ventilator Associated Pneumonia 38% 55% Urinary Tract Infection 17% 69% Skin & Soft Tissue Infection 26% 54% Ranji SR, Shetty K, Posley KA, Lewis R, Sundaram V, Galvin CM, et al. Volume 6--prevention of healthcare associated infections. Rockville, MD: Agency for Healthcare Research and Quality; 2007 January Report No.: AHRQ Publication No. 04(07)

34 Investing in Prevention Southeastern Ontario, 2008

35 The Bright Future Patient Centeredness SAPG HEAT HEI NES NQIS Clinical Effectiveness The HAI Agenda of the Future PFPI SGHD Clinical Safety