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