Post on 04-Jan-2016
ICNet – application to practiceDAVID TUCKER – DEPUTY DIRECTOR INFECTION PREVENTION AND CONTROL, GUY’S & ST THOMAS’ NHS FOUNDATION TRUST
Meeting the need Need for robust, supported data systems
Need for effective, integrated systems
Need for an ability to generate reliable and relevant data to support reports
Need for clear accountability
Robust, supported data systems
Once upon a time ………….
We had T-cards, note books, white boards, etc., etc.
And then we discovered computers
Many organisations developed in-house Access data bases
Some organisations developed more advanced stand alone systems that enabled data imports
Invariably the systems were built by an enthusiast who developed the programme in isolation
Inherent weakness due to vulnerability to staff changes, sickness/absence or worse
Inability to develop with new system changes, e.g. new pathology systems built on different platforms may not be able to support the home grown system
Data manipulation was “clunky” and invariably required intimate system knowledge
Need for effective, integrated systems
Staff need to be able to access information in one place, in a timely manner
Staff do not have the time to or inclination to use multiple systems
Ideally the systems should minimise staff any impact on staff productivity, and have a positive outcome
Systems need to be relatively intuitive – easy to build search questions etc.
Need for an ability to generate effective data to support reliable reports
Create bespoke routine reports to meet service needs◦ MRSA readmission◦ CDI-associated mortality◦ SSI surveillance activity◦ Antibiotic stewardship activity
Create reports to identify abnormal activity◦ Clusters of alert organisms or conditions
Create reports to validate reportable data, e.g. CDI, MSSA bacteraemia, incidents, etc.◦ Monthly sign off data
Support business case development and evidence savings/costs allied to HCAI
Outbreak management
Accessibility for clinical teams to self-manage cases
Report summary
Theatre list
MRSA in-patients
Letter maker
Need for clear accountability Majority of IPN activity is initiated through telephone or face to face contact
Historically record keeping was potentially poor, and if made not transferrable to patients’ records contemporaneously
Patient-centred advice needs to be either printed off for inclusion in hard copy records, or cut and pasted into electronic records
GSTT experience Initial programme based on Access data base
Developed in-house programme
First considered ICNet in 2004 – funding not available at the time
Successful business case in 2009, supported through changes in laboratory software programmes that made in-house programme unworkable
V6 has worked well but awareness of potential for expansion and introduction of NG has led to frustrations
Business case for NG approved in March 2014 – due installation by Feb 2015; also purchased ABXalert
Future expectations Enhanced mobile working of IPNs and improved interactivity with clinical staff
Devolved report generation by clinical teams
Innovation in SSIS management
Improved bed management
Improved outbreak management
Improved inter-operability of multiple systems
Device management
Conclusion The need for transparency and robust data systems is fundamental to supporting current and future IPC requirements
Any IT system that is applied must be able to have the flexibility to work within a range of systems, extracting and manipulating data as required to provide a full data set
The intra-operatability of systems must provide for accurate record keeping and contemporaneous recording of advice/decisions to support clinical teams and evidence those decisions
Systems must be developed that are flexible enough to enable the incorporation of future developments
Must be developed recognising that systems are a tool and not a reason for their existance