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You ever enter someone’s house and the smell just attacks you?
Let’s fix that before your guests start breathing through their mouths.
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#ServicePlusConnect #SPCApproved #HomeCare #FreshLiving #SPCTips
Primer on SPCs
5) The adage 'every system is perfectly designed to get the results it gets' helps with understanding variation. The results the system is producing as seen in the SPC (cont blood cultures, alert organisms, BSIs, SSIs, Abx ) are a result of system design. #SPCtips
A chart exhibiting unnatural variation indicates that something in the system has changed (for better or worse). Think about arrival time for work without disruption (natural variation), and when there is travel disruption (unnatural variation). #SPCtips
3a) The question you are asking of your SPC chart is this: Is the system that resulted in this chart stable and in control? To be able to do that you need to understand variation. Tomorrow variation. #SPCtips
Primer on SPCs
1) QI is not about SPCs per se. Its about monitoring and improving systems using SPCs, other QI tools, and your knowledge of the system and how it is operating.
#SPCtips
I would love to say back by popular demand. Alas retweet/likes were low. However, I am going to bring back #SPCtips Why? Because I do not know how you do IPC without them. Most governing docs say use QI but few know how. So here is a primer in tweet installments until the talk.
Reminder! Join our #QIPs webinar this week! Click on the link https://t.co/KJqiDcIAoz on Friday 15th @ 1-2pm to explore "getting started in research" with @loveebhc Don't forget to download MS Teams to join #infectionprevention #qualityimprovement @IPS_Infection @ips_epdc @IpsEcd
39 The Semmelweis effect had already started to wane prior to him leaving the building. Its always difficult to be sure if system improvements will be sustained. (Sorry for the time between tips delay) #SPCtips
38: 21 results in a row below the pre-intervention CL. The CL no longer runs through the centre of the results. The benefit of not changing the CL for each new result is that the impact of any change can be clearly seen and measured. The CL needs changed now. #SPCtips
37 Semmelweis: cadaverous material from the PM room is taken by doctors/students to the labour suite & causing puerperal fever. Options: stop the students from doing PMs, or disinfect the students after they leave the labour suite. He first erred & chose disinfection. #SPCtips
35 Results are above the upper and below the lower control limits. Outbreaks suggested by Semmelweis (p82). “…whole rows would become ill without a single patient in the row remaining healthy” Task: identify the outbreaks and remove from CL calculation #SPCtips
34 The proportion of deaths from puerperal fever in the Vienna hospital prior to the appointment of Semmelweis. Initial p chart. Tomorrow - how it is out of control and what happens next... #SPCtips
33. Tip 30 looked at opportunities to err. This time opportunities the IPCT could explore to help he system.
#SPCtips
32 “It has been my experience that the majority of errors and accidents come from the system and not the careless fault of workers.” W.E Deming evaluating the elements of the SENIC study. Am J Epid 1980 111:5;470-1 #SPCtips
31 “Continuous improvement in healthcare is not a contentious issue – but the means by which this may be achieved is the subject of much debate. A key aspect is the measurement, analysis and interpretation of the data variation”. M A Mohammed 2004 Qual Saf Health Care. #SPCtips
30 Here are examples of elements in the system that could result in poor data. It is important to identify what is preventing optimum practice. Its not so much about omissions or people getting it wrong, as finding what is provoking errors and preventing safety. #SPCtips
22 The first intervention is feedback, which may optimise performance. Once feedback begins, make space for new results. Don’t add new results to recalculate the CL, you want to determine if post-feedback performance is stable compared to the pre-feedback results. #SPCtips
No 20 Don’t forget to innovate alongside using your SPCs. The electric light bulb did not come from the continuous improvement of candles. (Oren Harair). #SPCtips
No 19 Possible topic areas for SPCs/QI during COVID - from readily available data:
1)ToTs – Time-on-Teams - enough IPC time to operate?
2)Failures to isolate &/or cohort – how is the organisation doing?
3)New acquired alert organisms – how well are we IPC doing #SPCtips
SPC tips No 18 Q: If you wanted to take the 'IPC temperature' of your organisation, where would you put the thermometer and how often would you measure it?
A: In every clinical area and continuously… Suggestions for topics to enable you to do that tomorrow. #SPCtips
No 17 “If we are to be more successful at CQI in healthcare, we must recognise that it embodies a science encompassing a range of disciplines from SPCs to human psychology.” Mohammed MA 2004 Qual Saf Health Care 2004 13 243-5 doi:10.1136/qshc.2004.011650 #SPCtips
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