A unique approach to the development of infection prevention and control resources for front-line health care workers

BACKGROUND: Despite successful efforts to reduce Meticillin Resistant Staphylococcus aureus bloodstream infections (BSI) and Clostridium difficile infection, Gram-negative BSI (GNBSI) have continued to increase in England. Public Health England (PHE) and NHS Improvement (NHSI) were tasked by the Minister for Health to lead the development of tools and resources to support healthcare workers to reduce these infections. AIM: To work with commissioners and providers of healthcare to collaboratively develop resources to support whole health economies to reduce GNBSI using a combination of behavioural insights and quality improvement methods. METHODS: We took a unique approach to develop these tools and resources using a combination of behavioural insights, quality improvement and front-line collaboration to ensure the tools and resources were designed around the needs of those who would use them. The approach taken was a stepwise iterative process in two distinct phases: a development phase and a testing phase. Both phases used a combination of behavioural insights, human factors, quality improvement and co-production methods to engage stakeholders in co-designing resources that would support them in their work to reduce GNBSI. FINDINGS: During the development phase, feedback from workshops and stakeholder reviews indicated that tools needed to be reduced, simplified, and communicated clearly. Stakeholders wanted tools that could be used by a cross-system group and indicated that leadership was key to ensuring resources were adopted to drive improvements. The final tools were published on the NHS Improvement GNBSI hub. This electronic platform had 30,000 visits between May 2017 and October 2018.