Quality statement 2: Collaborative action
Hospitals work with local health and social care organisations to assess and manage the risk of infections in hospitals from community outbreaks and incidents.
Healthcare‑associated infections are a serious risk to hospital patients, staff and visitors. Infections contracted outside a hospital setting can be brought into the hospital by patients, visitors and staff, and transmitted to others. By identifying and assessing potential risks from community outbreaks and incidents, hospitals can take action in collaboration with other local health and social care organisations, including public health services, to reduce the risk of infection.
a) Evidence of local arrangements for hospitals to monitor the risk of healthcare‑associated infections from incidents and outbreaks in the community.
Data source: Local data collection.
b) Evidence of local arrangements for collaborative working between hospitals and other local health and social care organisations to investigate and manage the risks of healthcare‑associated infection from incidents and outbreaks in the community.
Data source: Local data collection.
Incidence of healthcare‑associated infections.
Data source: Local data collection and national data collection including 2015–16 NHS Outcomes Framework indicator 5.2 (MRSA and C difficile); 2015–16 Clinical Commissioning Group [CCG] Outcome Indicator Set indicators 5.3 (MRSA) and 5.4 (C difficile). National data derived from the Mandatory Surveillance of MRSA, MSSA, E coli and C difficile published by Public Health England.
What the quality statement means for service providers, health and social care practitioners, and commissioners
Service providers (hospitals) participate in joint working initiatives with other health, public health and social care organisations beyond mandatory requirements to share information on outbreaks and incidents in the community, and assess and minimise the risks. Joint working initiatives can include agreeing a governance structure and lines of accountability between organisations; joint development of strategy, policy, pathway and shared targets; sharing information from risk assessments; and investigating and managing outbreaks and incidents of healthcare‑associated infections.
Health and social care practitioners in secondary care (including hospital clinicians, nursing staff and allied healthcare professionals) participate in joint working initiatives and implement measures introduced in response to community incidents and outbreaks to minimise the risk of infections in hospital.
Commissioners (such as clinical commissioning groups) ensure that they commission services from hospitals that can demonstrate that they work collaboratively with local health and social care organisations to assess and manage the risk of infections in hospitals from community outbreaks and incidents.
People receiving treatment in, or visiting, hospitals can expect the hospital to work with other local health and social care organisations to help prevent infections in the community spreading into the hospital. As a result of this work, hospitals may occasionally have to change the way that people receive treatment or visit hospitals. For example, a ward may be closed to visitors, or a person may be admitted to a single room to help prevent infections spreading.
Healthcare-associated infections: prevention and control (2011) NICE guideline PH36; quality improvement statements 3 and 6
An outbreak is usually defined as 2 or more people experiencing a similar illness linked in place and time, or a single instance of a rare or particularly harmful organism. An outbreak is only declared following the identification, notification and investigation of an incident. For example, laboratory results may confirm that 2 illnesses are caused by the same organism or strain of an organism.
An incident includes events or situations needing investigation to see if action or management to reduce a risk is needed. An incident can also include a single case of a disease. In the context of this statement, an incident is taken to include any incident with the potential to expose people to infection risk.