1. Rania Mohamed El-Sharkawy
rania.elsharkawy@alex-mri.edu.eg
Lecturer of clinical chemistry, MRIAlexandria University ,CPHQ,LSSGB
Health governance –MRI-Alex university
unit coordinator
IHI Egypt & NAHQ member

2. Infection control indicators
between monitoring and improvement

3. WHO recommendations ………
GENERAL CONCEPTS
•Health care-associated infections lead
to death, disability and excess medical
costs.
•Infection prevention and control
program will reduce the cost if applied
and monitored effectively

4. WHO recommendations ………
GENERAL
CONCEPTS
Health-care facilities must implement
infection prevention and control
policies supported by institutional
management.

5. WHO recommendations ………
GENERAL
CONCEPTS
• Infection prevention and control
maximize patient outcomes and is
part of the institute's responsibility to
provide effective, efficient and quality
health services

6. WHO recommendations ………
Approach
An overall
approach to an
infection
prevention and
control policy at
the health-care
facility
level is based
upon
Management Communication
and education
Indicators
&
Audits

7. KPI = Key Performance
Indicator

8. Objectives
How to select and implement indicators
+
=
• awareness of maintenance performance.
How to use indicators for improvement

9. Determine………

10. What are indicators?
KPIs are quantifiable measurements that
reflects the critical success factors of a
business.
KPIs have a major impact on the
performance of the business
KPIs are quantitative measures of a
specific part of a process or of an
outcome.

11. What is a KPI?
KPIs track performance against established goals.
•Key Performance Indicators (KPI) are related to goals or
objectives and
provide a means for tracking performance against that
goal or objective.
•KPI are used to assess current performance (LAG) and
guide action toward improvement
and enhancement (LEAD)
Predict
LEAD
Current
LAG

12. Why indicators?
Tool for performance monitoring
• Track changes over time
Identify areas that need further study
and investigation

13. Choice of indicators
Step 1: Define Organization`s Strategy
Step 2: Audit Existing Measures
Step 3: Develop Measures
Step 4: Educate and train
Step 5:Analyza and report

14. Determine…
How to determine the indicator ?
 Process flow chart
 Observation of process
 Process outcome

16. KPIs should be?
Surgical VS Prosthetic
1-Related to quality
dimension/s(efficiency, efficacy,
appropriateness, availability,
timelines, effectiveness, continuity )

17. KPIs should be?
2- Specific
3-Measurable
4-Aligned
5-Timely
6-Realistic
7-Ethical
8-Recorded

18. KPIs are not…………
WHAT ARE KPI’s NOT?
1-GROUP OF METRICS
• NOT EVERYTHING WE MEASURE IS A KPI !
2- STATISTICS
•THESE CAN HELP DEFINE KPI’s
3- A TOOL FOR BLAME
4- WALL PAPER

19. Types of indicators
• Efficiency of PROCESS
• Outcome ( effectiveness)
•Monitoring &measurement of
Processes

20. KPIs are tools for collection of
data
Types of indicator
 Sentinel-event
 Aggregate data

21. KPIs are tools for
collection of data
 ContinuousAggregate data
variable
 Rate –based

22. KPIs are tools for collection of
data
Types of indicator
 Sentinel-event
e.g Intrahospital mortality of patients
due to infections within two post
procedure days (MMR)

23. KPIs are tools for collection of
data
Aggregate data
 Continuous-variable
e.g No of complains or
incidents monthly raised /
department

24. KPIs are tools for collection of
data
Aggregate data
 Rate –based
e.g Proportion of staff observed performing
hand hygiene before
attending patients

25. Improvement…
How to use it for improvement ?
 HOW TO DETERMINE THE
desired performance ?

26. HOW TO DETERMINE THE
desired performance ?
 Compare against benchmark
 Refer to guidelines
 Compare self performance
versus same circumstances in the
same period

27. Core infection prevention and control interventions for
health-care facilities
process
Indicator
Hand hygiene
Proportion of staff
observed performing
hand hygiene before
attending patients
Proportion of staff
observed wearing
gloves when exposure
to blood or body fluids
is anticipated
Average time between
admission and
isolation for
tuberculosis patients
Proportion of
intravenous lines
inserted using aseptic
technique
Proportion of rooms
appropriately
disinfected after
patients' discharge
Proportion of
sterilized devices
whose sterility is
documented with test
strips
Three-dose hepatitis B
vaccine coverage
among nurses,
physicians and
laboratory technicians
Personal
protective
equipment
Isolation
precautions
Aseptic technique
Cleaning and
disinfection
Sterilization
Immunization and
exposure
management

28. Hand washing process indicator

29. HAND WASHING KPI
Effectiveness
% of hand washing frequency = Number of
times employees did wash their hands /
Number of times employees should have
washed their hands)

30. HAND WASHING KPI
Outcome efficiency
% In-compliance= Number of
times employees did wash
hands with method in
guidelines /
Number of times employees
should have washed their
hands

31. Compare self performance versus same
circumstances in the same period

32. Performance over time

34. Chart showing trend

35. Self-Reported Factors for Poor
Adherence with Hand Hygiene
Hand washing agents cause irritation and
dryness
Sinks are inconveniently located/lack of sinks
Lack of soap and paper towels
Too busy/insufficient time
Understaffing/overcrowding
Patient needs take priority

36. Corrective actions
for improper compliance
1. Have a clear written policy and
procedure
2. Educate personnel continuously
3. Easy access to hand washing facilities

37. Provide an environment that
supports hand washing - NOT Like
THIS……………………………………..LIKE THIS
Bad hand washing facility
Encouraging hand washing facility

38. Corrective actions
for improper compliance
4. Careful selection of products
5.Monitor the technique and provide
indicators
6. Record and analyze the results to
improve the compliance

39. Cleaning and disinfection
KPI………

41. Cleaning and disinfection KPI
Effectiveness (rate based indicator)
Proportion of rooms appropriately
disinfected after patients' discharge(WHO
indicator)

42. Cleaning and disinfection KPI
Efficiency
No of facilities reaching the desired
total number of acceptable limit /
facilities

43. For improvement
In any organization…
It is better to have………………….

44. HAND WASHING KPI

45. Dashboard for indicators……….

46. DASHBORD MODEL

47. DASHBOARD MODEL

48. Other Tips for Good KPIs
REMEMBER…….

49. 1. Have them!
2. Align them to mission, vision, strategy
3. Test them for validity and
reliability, practicability
4. Discuss them and review them. Are
they really key?
Don’t overestimate their importance!
5. Differentiate between lag and lead
indicators (determine the type)

50. 6. Benchmark them
7. KPI should lead to change
8. Use them for Improvement