Using a PDSA cycle of improvement to increase preparedness for, and management of, norovirus in NHS Scotland

Summary Background The 2009–2010 norovirus season was reported anecdotally by infection prevention and control teams (IPCTs) to be one of the worst seasons in Scotland. At its peak, Health Protection Scotland's (HPS) weekly point prevalence identified that 53 wards were closed. Aim To develop a...

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Bibliographic Details
Published in:The Journal of hospital infection 2012-10, Vol.82 (2), p.108-113
Main Authors: Curran, E.T, Bunyan, D
Format: Article
Language:English
Subjects:
Biological and medical sciences
Caliciviridae Infections - epidemiology
Caliciviridae Infections - prevention & control
Communicable Disease Control - methods
Cross Infection - epidemiology
Cross Infection - prevention & control
Health Policy
Health Services Research
Humans
Incidence
Infectious Disease
Infectious diseases
Medical sciences
Norovirus - isolation & purification
Norovirus outbreaks
Preparedness
Quality improvement
Quality of Health Care
Scotland - epidemiology
System improvements
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Summary:Summary Background The 2009–2010 norovirus season was reported anecdotally by infection prevention and control teams (IPCTs) to be one of the worst seasons in Scotland. At its peak, Health Protection Scotland's (HPS) weekly point prevalence identified that 53 wards were closed. Aim To develop an annual cycle of learning lessons and improving systems to reduce the impact and incidence of norovirus outbreaks in Scotland. Methods An analysis of two end-of-year norovirus season evaluations (2009–2010 and 2010–2011) by IPCTs in Scotland using a national Plan, Do, Study, Act (PDSA) model. Findings The first evaluation (2009–2010) identified that IPCTs responded well when outbreaks were reported, but were not optimally prepared for the season. In addition, IPCTs had little data to describe their particular problems in detail. HPS planned for the 2010–2011 season with tools to optimize preparedness and norovirus management. The second evaluation (2010–2011) identified much more proactive responses to both preparedness and norovirus management. Conclusion This national PDSA cycle has led to system improvements designed to reduce the incidence and impact of norovirus in NHS Scotland. The incidence of norovirus was reduced in the 2011–2012 season; however, confounding from the variation in circulating viruses makes it difficult to measure any effect of the system improvements. As noroviruses challenge the health service every year, mainly in winter months, the end-of-season evaluations can be used to improve planning for subsequent seasons to share and demonstrate good practice. As more years of data become available for analysis, the impact of system improvements will become measurable.
ISSN:0195-6701
1532-2939
DOI:10.1016/j.jhin.2012.07.007