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Jon and Daenerys in the snow

Winter is coming, be SAFE

  • The need for world-class SAFE NHS and SAFE Care Homes Infection Prevention and Control assurance

According to the Academy of Medical Sciences 'Preparing for a challenging winter 2020/21' there "must be a period of intense preparation for our reasonable worst-case scenario for health in the winter".

Most of us could have prepared better for the onslaught of the COVID-19 Coronavirus that swamped us in March 2020, "if only we had known it was coming".

This time we know.

Have you now done everything you wished you had done before the first wave hit our shores? Have you done all you can to prepare for the 'reasonable worst case' for the Winter of 2020-21?

Or are you trusting to us having better luck over the Winter than we did in the Spring?

Infection Prevention is the single area where the largest number of us can do the most effective activity to reduce the size of the next tidal wave about to hit and protect the vulnerable, health workers, the economy, public health and a near normal life.

We have been working collaboratively on Infection Prevention and Control since before and throughout the pandemic with Wirral Community Health and Care NHS Foundation Trust.

Infection Protection and Control is a subject which has increased in importance tenfold since the pandemic.

Hand Hygiene as we all know is one of the key controls over the spread of the Covid-19 Coronavirus.

Everyone today, whether healthcare worker, care home worker, key worker, office worker, or member of the public is more aware of what hand hygiene really means, and its importance, than ever before.

So, what is important today and over the coming Winter? Is the operating procedure for hand hygiene in place and understood in each setting? Are the transfer points marked or known? Are all staff, patients, residents, visitors, complying with the locations, frequency and duration of hand washing?

How will you know, across all settings, all wards, care homes, offices, or other locations, what the compliance of people is on hand hygiene, as one of several ever more critical procedures?

Have you prepared?

Our best practise approach to maximise compliance with all relevant guidance is

  • to have clear, easily understood, guidance, known by the relevant people
  • to track, through self-assessment and audit, the levels of compliance
  • to have easy, real-time access to the data on compliance, both level of compliance and breadth of assessment / audit completionto be able to easily identify low rates or lapses in compliance or completion and take remedial actions quickly.

Easy to write, harder to do, hardest of all to assure that it is being done everywhere it is essential, to the necessary level, fast enough.

We know that printed operating procedures manuals, paper forms and checklists, compiled results into multiple spreadsheets, report generation, review meetings, minutes and action lists, allocations of workplan actions, successfully completing the actions, and the cycle of retesting and auditing does work.

We also know that approach is inherently tedious, slow, error prone and unengaging. Not good characteristics of something we are going to rely on to catch problems and improve our procedures quickly enough to slow the spread of the disease through the days, weeks and critical months of the COVID-19 Winter.

Too many of our health, care and other public settings are relying on just such a paper and spreadsheet process, not just for hand hygiene, but for the very many processes and procedures that have had to be modified to improve infection prevention and control dramatically.

What can be done instead?

By happy circumstance prior to the pandemic, InPhase and Wirral Community Health and Care NHS Foundation Trust had undertaken digitisation of the quality assurance processes, and developed a suite of digital tools, including for example hand hygiene audit, tracking and reporting for over 1,700 staff.

This suite has been the foundation for creating SAFE, a digital quality Standard Assurance Framework for Excellence.

Lessons were learned, improvements were made, success was had, engagement was achieved with over 1,500 staff logging in and using the system.

Today, within Wirral SAFE over 80 different SAFE process audits are tracked, online in real time, as well as 338 NICE guidelines, 39 Medicine Management Inspections, 415 team leader checklists, and over 2,200 hand hygiene inspections have been tracked, along with CQC assessment, CAS alerts, and Social Care standards, Procedural Documents, 1000's of action plans and the real-time SAFE COVID-19 dashboard - all of which run 24/7 in the cloud.

Over the 'quiet period' of the pandemic further NHS Trusts, including renown leading trust Royal Wolverhampton NHS Trust, as well as the UKs largest private hospital provider Circle Group BMI have upgraded in preparation for Winter and are now deploying the same InPhase clinical quality Oversight solution.

The SAFE approach rapidly won commendations, awards, and grant funding to expand its use to other organisations, which has led to the SAFE Care Homes solution.

Care for Care Homes!

Government funded, SAFE Care Homes was developed and is now being deployed for over 100 Care Homes in its first geographic area deployment pilot. This is an successful collaboration between an industry partner, InPhase, NHS and Social Care provider Wirral Community Health and Care NHS, Wirral Clinical Commissioning Group, Wirral Council and multiple Care Home providers.

SAFE Care Homes provides a cloud-based solution for every Care Home setting for the essential standards for Care Home COVID-19 Infection Prevention and Control safety.

The system includes checklists and audits devised by expert health teams for everything from resident bedrooms, linen and laundry management, general dining and lounge areas to communal toilets, dirty utility/ sluice, and safe discarding of waste, and a PPE checklist, checklist compliance and completion reporting, and improvement action planning, allocation and completion tracking.

Possibly the biggest impact on infection Prevention and Control, after hand hygiene, is PPE.

The InPhase platform can also support that the PPE checklist drive into directly actionable information, with the option to include a PPE stock level tacking and ordering dashboard, giving each care home the ability to see its current PPE stock levels, PPE usage rate, projected date for ‘low stock’ warning level and compile it’s stock ordering requirement. The InPhase platform can also directly place orders for PPE from a reliable NHS PPE supplier.

With availability of PPE over the Winter already in question for many suppliers, the real-time safe stocking levels tracking and a reliable first or back-up supply could be life-saving in our Care Homes this Winter.

With a Department of Health commitment to funding PPE for Care Homes this winter, the SAFE system can also directly place orders for PPE from a reliable NHS PPE supplier.

In conclusion all I have GOT to say is "Winter is Coming" - get your Infection Prevention and Control assurance system upgraded before you are drowned in the second wave.

Robert Hobbs

Chief Executive Officer

InPhase’s Chief Executive and Founder, Robert has been the visionary leading InPhase to be one of the UK's leading providers of management, governance and assurance solutions, and helping organisations align their actions and goals more easily and efficiently with InPhase's suite of integrated apps.

IPC, Covid