Raising the Profile of Facilities Management (FM) in Healthcare – Managing Performance of Infection Control

Hospital-acquired infections (HAIs) are a major problem in the National Health Service (NHS) in the United Kingdom (UK). One reason for this is the failure of healthcare officials to tackle the root causes of HAIs. There is sufficient epidemiological evidence showing that HAIs can occur because of, inter alia, poor performance of Healthcare Maintenance (HM) services. Despite this link, HM has not received the level of attention it deserves from healthcare authorities. As a result, some HM managers do not measure the performance of HM services in infection control (IC). The aim of this research study therefore, is to improve the overall level of performance of HM services in the control of HAIs in the NHS. Hence, the adoption of six research objectives to identify the critical success factors (CSFs) and key performance measures in the control of maintenance-associated HAIs. In addition to an in-depth literature review, a content analysis approach was adopted to establish the link between HM services and HAIs. Conversely, CSFs and performance measures in HM in IC were identified through the application of ground theory analysis. An exploratory case study was then conducted with two NHS trusts. The results of the exploratory case study revealed that some HM managers did not have the required knowledge to fulfil the research need of the study, i.e. development of the performance measurement system (PMS). Therefore, the Delphi approach was considered suitable to achieve the aforementioned need. In total, eight CSFs and fifty-three key performance measures are identified for reducing the burden of maintenance-associated HAIs in hospitals. For example, establishing clear lines of communication between the IC team and HM unit is crucial in the prevention of maintenance-associated HAIs in hospitals. Dust prevention is also identified by the healthcare experts as an important measure to prevent the transmission of maintenance-associated HAIs in high-risk patient areas. Through the application of the Balanced Scorecard (BSC) approach, the CSFs and key performance measures were categorised into a performance matrix. The result was then used to develop a performance measurement system (PMS) to control maintenance-associated HAIs. Both performance tools i.e. the BSC matrix and PMS could be applied by HM managers to reduce rates of maintenance-associated HAIs in hospitals

PROCES KSZTAŁCENIA W ZAKRESIE PROFILAKTYKI I KONTROLI ZAKAŻEŃ ZWIĄZANYCH Z OPIEKĄ ZDROWOTNĄ W EUROPEJSKICH INSTYTUCJACH SZKOLNICTWA WYŻSZEGO – BADANIE JAKOŚCIOWE

[EN] Healthcare-associated infections (HCAIs) affect the lives of patients through prolonged stay in hospital, illness, or even death, incurring signifi cant costs to both healthcare systems and society. Research shows that during a stay in a hospital, approximately 20% to 30% of patients are diagnosed with at least one infection. Openness, fi ne interpersonal and communication skills as well as adequate opportunities for training courses for healthcare staff contribute to promoting HCAI/HAI prevention. HCAI/HAI-related education should contribute to widening knowledge and mastering practical skills. It is assumed that lecturers, professional instructors, and coordinators create a signifi cant foundation for professional development and social interactions by applying interactive pedagogical models. [POL] Zakażenia związane z opieką zdrowotną (Healthca- re associated infections, HCAI) wpływają na życie pacjentów poprzez przedłużony pobyt w szpitalu, chorobę, a nawet śmierć, powodując znaczne koszty zarówno dla systemów opieki zdrowotnej, jak i spo- łeczeństwa. Badania pokazują, że podczas pobytu w szpitalu u około 20% do 30% pacjentów diagnozuje się co najmniej jedną infekcję Otwarte podejście, wysokie umiejętności interpersonalne i komu- nikacyjne, a także odpowiednie możliwości szkoleń dla personelu medycznego przyczyniają się do promowania profi laktyki HCAI/ HAI. Kształcenie w zakresie HCAI/HAI powinno przyczynić się do poszerzenia wiedzy i opanowania praktycznych umiejętności. Zakłada się, że wykładowcy, profesjonalni instruktorzy, koordy- natorzy tworzą istotne podstawy rozwoju zawodowego i interakcji społecznych poprzez stosowanie interaktywnych modeli pedago- gicznych

When Antibiotics Fail: The Expert Panel on the Potential Socio-Economic Impacts of Antimicrobial Resistance in Canada

Antimicrobials are life savers in Canada, enabling modern healthcare and playing a central role in agriculture. They have reduced the economic, medical, and social burden of infectious diseases and are part of many routine medical interventions, such as caesarean sections, joint replacements, and tonsillectomies. As use of antimicrobials has increased, bacteria evolved to become resistant, resulting in drugs that are no longer effective at treating infections. Antimicrobial resistance (AMR) is increasing worldwide, and with widespread trade and travel, resistance can spread quickly, posing a serious threat to all countries. For Canada, the implications of AMR are stark. When Antibiotics Fail examines the current impacts of AMR on our healthcare system, projects the future impact on Canada’s GDP, and looks at how widespread resistance will influence the day-to-day lives of Canadians. The report examines these issues through a One Health lens, recognizing the interconnected nature of AMR, from healthcare settings to the environment to the agriculture sector. It is the most comprehensive report to date on the economic impact of AMR in Canada

The Role of Facilities Management in the Control of Healthcare Associated Infections (HAI)

A growing body of evidence now exist, which suggests that Healthcare Associated Infections (HAI) are a major cause of morbidity and mortality. There is, however, a paucity of empirical knowledge and evidence-base of the role of Facilities Management (FM) in the control of HAI. Therefore, the main aim of this research was to investigate the role of FM in the control of HAI. The focus of the study is on domestic services. The research methodology of the study employed both qualitative and quantitative approaches. Altogether, 81 interviews were carried out involving experts in the areas of FM and HAI in the National Health Service (NHS). The qualitative data collected was analysed using content analysis. The qualitative data sets were then augmented by 412 completed questionnaires. The quantitative data sets obtained were subjected to rigorous statistical analyses. The study concluded that FM has a major role to play in the control of HAI, mainly in terms of cleaning, catering, waste management and laundry and linen services. However, FM is yet to feature prominently in the ‘control of HAI agenda’ in the NHS. There is evidence and lack of clarity on the roles and clear lines of communication between the major players in the control of HAI in FM services. There is a relatively low level of integration between the clinical teams and FM teams in the control of HAI. The roles and benefits of knowledge management and performance management are yet to be fully exploited in FM services in the control of HAI. A Performance Management Framework (PMF) for the control of HAI in FM services (particularly in domestic services) have been developed, tested and validated. The study recommends, inter alia, that FM should be made integral to the core services in hospitals for effective control of HAI. A national training and education framework for FM teams should be developed in order to enable them to carry out their work to the highest standards. There is also a need to adhere to a Performance Management Framework (PMF), which allows FM services to monitor and measure the performances in the control of HAI. The research methodology employed in this study could be replicated in different countries, including developing countries. There is also scope to research the key motivational constructs associated with effective knowledge sharing between the domestics and ICT teams in the control of HAI

Countering Drug Resistance in the Developing World: An Assessment of Incentives across the Value Chain and Recommendations for Policy Interventions

The emergence and spread of drug resistance is draining available resources and threatening our ability to treat infectious diseases in developing countries. HIV/AIDS, tuberculosis, malaria, diarrhea, and respiratory tract infections continue to be the leading causes of death in many developing countries, many of which have already been exacerbated by resistance. Countering drug resistance often involves complex tradeoffs between activities such as the development of new products; ensuring treatment heterogeneity; and guaranteeing quality and ensuring systemic availability, affordability, compliance, adherence and rational use of drugs and diagnostics. A careful understanding of all the players involved in the resistance problem and their incentives to engage in activities that counter drug resistance is crucial for policymakers and resource managers in a range of institutions and agencies. This paper presents results gathered through quasi-structured interviews to understand these incentives and develop recommendations to better align them with resistance-countering activities.drug resistance; developing countries; HIV/AIDS; supply chains; drugs; diagnostics; recommendations; policy

Enhancing home based care for HIV patients using an advisory expert system

South Africa has one of the highest Human Immunodeficiency Virus (HIV) prevalence rates in the world. People living with HIV/AIDS experience many unrelieved symptoms. Nutritional care and support are important in preventing development of nutritional deficiencies. Home remedies can extend and improve the quality of their lives. Home remedies treatment involves eating healthy food, avoiding certain types of foods, psychological and emotional support and practicing hygiene to avoid skin infections (Sizani, Bandile; Nikiwe 2012). HIV/AIDS treatment and management strategies require ongoing management and support. In this research, we work with people from a clinic in Gugulethu Township in Western Cape, South Africa. The area has high prevalence of HIV (Ministry of health South Africa 2011). Most of the HIV patients in this area access medical information by walking long distances to the clinic. Most of these patients are poor and sometimes cannot afford to visit the clinic regularly for medical advice. In this township there is scarcity of health care workers (HCWs). The HCWs toil on many fronts to meet the enormous demand for the HIV/AIDS services but they are not able to meet the patients' needs. The aim of this research is to empower HIV-patients to self-manage the HIV-related symptoms which they experience. We investigated the way in which the HCWs deliver information to the patients. We interviewed the patients to understand what measures they take to manage the symptoms which they experienced. Consequently, we developed an advisory expert system to enhance Home-Based Care for HIV patients. An advisory expert system is defined as a computing system which is capable of representing and reasoning about some knowledge–rich domain, with a view to solving problems and giving advice (Gustafson et al. 1994). Since South Africa has high mobile phone penetration and most of the patients own them, we opted to use mobile phone as a tool to access the information provided by the advisory expert system. The system was then deployed at the clinic. We trained both HCWs and patients how to use the system. The findings were captured and reported after a six month deployment of the system. The results show that our system can be used as an effective tool to disseminate nutritional and psychological support information to HIV- patients in Gugulethu. The system is simple, yet practical. It helps the patients to self-manage the HIV-related symptoms which they experienced and at the same time, saves time and cost for both HCWs and the patients

An integrated stewardship model: antimicrobial, infection prevention and diagnostic (AID)

Considering the threat of antimicrobial resistance and the difficulties it entails in treating infections, it is necessary to cross borders and approach infection management in an integrated, multidisciplinary manner. We propose the antimicrobial, infection prevention and diagnostic stewardship model comprising three intertwined programs: antimicrobial, infection prevention and diagnostic stewardship, involving all stakeholders. The focus is a so-called ‘theragnostics’ approach. This leads to a personalized infection management plan, improving patient care and minimizing resistance development. Furthermore, it is important that healthcare regions nationally and internationally work together, ensuring that the patient (and microorganism) transfers will not cause problems in a neighboring institution. This antimicrobial, infection prevention and diagnostic stewardship model can serve as a blue print to implement innovative, integrative infection management

Technologies for Development: From Innovation to Social Impact

Development Engineering; Technologies for Development; Innovation for Humanitarian Action; Emerging Countries; Developing Countries; Tech4De