Posted on 30-January-2014   by Dee Ward

Daniels Sponsors: IPS Team Award 2013 | Winners: NHS Coventry & Warwickshire

We sponsored the 2013 IPS Team of the Year Award which went to the Infection Prevention and Control Team, University Hospitals Coventry and Warwickshire NHS Trust (the team’s representative Kate Prevc accepted the award on behalf of the team).

I was interested to hear more about the campaign that earned them their nomination, so I spoke with Kate to find out more about the award and what winning meant to her and her team. (If you’d like to know more about how social media played a big part in the success of their campaign – read my post on that here.)

The criteria for entry into this award category were that the entrants should have implemented an initiative to improve practice within their immediate area or more widely across their organisation, community or population health. So, the applicants should:

• try to demonstrate links to the IPS Strategy themes of Inform, Promote and Sustain and its objectives
• try to map their initiatives against the IPS Outcome Competences Framework
• aim to demonstrate clear outcomes and be able to show that their initiative has improved practice or has a significant potential to improve practice in IPC and reduced risks to patients and service users.

The IPS’ ultimate goal for this award was that the overall initiative should demonstrate innovation, role excellence and inspire others.

The Yorkshire branch of the IPS nominated the team for the award after Kate and her team developed and evolved working practices in line with the outcome competencies for practitioners in infection prevention and control. The team collect data, analyse it, and then create campaigns to improve knowledge and practice. Kate told me that they are re-branding as a support and knowledge resource who work closely from within, rather than the historical external “police force” pointing out areas of poor practice.

More about the campaign that earned them the nomination…

The Noro-virus and a challenging C diff trajectory indicated a scattergun approach to sending specimens – it reflected that no clinical judgement was applied. (For example: a failure to recognise patterns of constipation, followed by overflow, etc.) Kate and her team needed to return judgement to staff with guidance and support – the team recognised that staff are expected to risk assess in times of crisis but not supported to do so.

The team’s “Stoolsmart” campaign began on Valentine’s Day (2013) with a Valentine card, including: A diarrhoea assessment chart, stool monitoring chart and contact details including the team’s Twitter address. (Kate and her team have found Twitter to be a powerful tool for communication and motivating staff. Having external reinforcement was vital to increasing buy-in, and the use of pictures of Awards on Twitter created positive competition.)

They introduced a number of initiatives including:

1. Stoolsmart charts showing wards historical data including improvements and their trajectory for 2013-14
2. A check and challenge initiative where all staff -Doctors, physiotherapists etc were rewarded for a correct answer – generating healthy competition and healthy discussion between groups.

These initiatives identified areas for education, for example medical staff still requested three specimens for C diff clearance. The team collected laboratory data assessing number and type of specimens against positive results, monitoring the improvement, such as increases from admission areas facilitating robust assessment and prompt treatment. Inappropriate “formed stools” which they followed up, identified a gap in knowledge about what tests laboratories perform and under what conditions. The team created charts to show numbers of patients that were asymptomatic Clinicians’ who did not suspect C diff but had a positive result, showed a lack of understanding around colonisation which led to inappropriate treatment, possibly missing another cause, or inappropriate treatment – asymptomatic patient becoming active.

Using this data Kate and her team visited clinical areas and clinicians in real time and used patient and data to educate and support, and understand what had been requested and why.

The results…

Their campaign began in early February (2013). C diff numbers for December were 7; January 10; February 8; March 5 (back on monthly trajectory). They decreased their formed stool list by over 90 %. And for the last recorded quarter they had the lowest number of inappropriate samples since their records began. All C diff incidents are followed up by an RCA to ensure safe practice.

The best outcome from the work…

The staff are motivated and questioning – they ask the team to help prevent potential issues rather than trying to hide them when they become issues. The campaign and team are still in their infancy but Kate shared that they have year-long campaigns planned. Kate also said that the feedback from other IPS groups nationally and internationally has been inspirational, and when this is fed back to the staff or have contributed – it serves as proof that they are innovative, exceptional role models.

How will NHS Coventry & Warwickshire use this recognition for good?

Kate said that they have been invited to visit many other Trusts to share the work that we have undertaken at UHCW. They continue to work with staff to support them and to educate using a campaign based approach. They are still working on changing attitudes to Infection prevention and control.

I think you’ll agree that Kate and the team have done a fantastic job that has stretched beyond the remit of this award and they’ve managed to create positive ripples within the NHS which will impact communication and ultimately caring for the patient. Well done!

We are sponsoring this award again in 2014 – so watch this space!

Dee Ward

Dee is the Customer Support and Marketing Manager at Daniels. She is the key force behind a motivated and responsive team who support the Daniels customers and sales representatives day in and day out.