1. Storyboard Submission on 12-04-2015
25/5/2018
SHINe LSI
DESIGNING A HIGHLY RELIABLE PROCESS FOR HAND HYGIENE

2. Storyboard Submission on 12-04-2015
25/5/2018
Singapore National Eye Centre (SNEC) is the designated national centre within the public sector healthcare network. Since its opening in 1990, SNEC has achieved rapid growth and currently manages an annual workload of 250,000 outpatient visits, 14,000 major eye surgeries and 13,000 laser procedures
Today, SNEC's facilities include an 8-storey tower block and a 4 storey podium block and consists of 3 floors of outpatient clinics supported by comprehensive ancillary facilities and 9 operating theatres with day recovery suites.
Insert some important descriptive demographics of your healthcare facility. You can also include a picture.

3. DESIGNING A HIGHLY RELIABLE PROCESS FOR HAND HYGIENE
Storyboard Submission on
25/5/2018
DESIGNING A HIGHLY RELIABLE PROCESS FOR HAND HYGIENE
Team Members
SNC Eunice Loh TC (Program Manager)
Ms Pan Chong (Data Analysis)
SSN Cheryl Kek (Nursing)
SSN Linda Siew (Nursing)
SSN Foo Cui Shan (Nursing)
Ms Yap Xin Yu (Pharmacy)
Ms Nazimah Saini (OIT)
Sponsors
Ms Low Siew Ngim (Director, Nursing)
Ms Charity Wai (COO)
Dr. Dirk de Krone (Director, Innovation)

4. Storyboard Submission on 12-04-2015
25/5/2018
TEAM SNEC LSI
Please insert a picture of your improvement team!

5. Project objective Aim to design a highly reliable process for hand hygiene, so that the hand hygiene compliance rate will be increased to 80% within SNEC
Measurements
Direct observation of hand hygiene opportunities and compliances
SUE – MAYBE WE SHOULD USE THE MFI QUESTIONS FOR THIS SLIDE AND THE OTHERS THAT FIT ... REINFORCING THE METHOD? WHAT ARE YOU TRYING TO ACCOMPLISH?
Please insert your improvement Aim. You may include an overall aim and the individual aims for each of the work streams to which your team has committed.

6. Storyboard Submission on 12-04-2015
25/5/2018
Pilot site
Ophthalmic Investigative Technologists (OITs)
Hand hygiene data collected in SNEC over a twelve month period has shown
that the allied health group had a low compliance rate
Health Care Worker Group
Compliance Range % (Median)
Medical ( n= 88)
27 to 31.3
Nursing ( n= 211)
67.9 to 68
Ancillary ( n= 148)
43 to 44
Allied Health (n=68)
24 to 35
Within the allied health group, there are different distinct roles. the
Ophthalmic Investigative Technologist Group (OIT) was selected as
the pilot site
Allied Health Group
Staffing Numbers
Ophthalmic Imaging 6
Optometrist, 22
Orthoptist, 5
Ophthalmic Investigative Technologist (OIT) 15
Pharmacy Staff 20
SUE – MAYBE WE SHOULD USE THE MFI QUESTIONS FOR THIS SLIDE AND THE OTHERS THAT FIT ... REINFORCING THE METHOD? WHAT ARE YOU TRYING TO ACCOMPLISH?
Please insert your improvement Aim. You may include an overall aim and the individual aims for each of the work streams to which your team has committed.

7. Storyboard Submission on 12-04-2015
25/5/2018
PDSA 1
Assumption:
In order to understand a little more of their background, different individuals from the groups were interviewed. This led to the hypothesis that due to the minimum hospital attachment and hospital based activities (in some cases, this component was missing) there was a lack in the emphasis on the importance of hand hygiene
Plan:
A training session on hand hygiene is planned for OIT team. Knowledge assessment survey will be conducted before and after the Training session
Please insert your improvement Aim. You may include an overall aim and the individual aims for each of the work streams to which your team has committed.

8. Storyboard Submission on 12-04-2015
25/5/2018
PDSA 1
Do:
The training session was conducted on 17 June 2014
Please insert your improvement Aim. You may include an overall aim and the individual aims for each of the work streams to which your team has committed.

9. Storyboard Submission on 12-04-2015
25/5/2018
PDSA 1
Study:
The training results in significant improvement in knowledge on hand hygiene. The hand hygiene compliance rate was improved from 45.1% to 52%. However, due to lack of baseline data, the significance is unknown
Please insert your improvement Aim. You may include an overall aim and the individual aims for each of the work streams to which your team has committed.

10. Storyboard Submission on 12-04-2015
25/5/2018
PDSA 2
Assumption:
The acceptance of the current hand hygiene product may have affected the compliance rate of hand hygiene. It was assumed that a new product will increase compliance.
Plan
Another hand hygiene product will be tested by OIT, survey will be conducted after the test
Do:
The new hand hygiene product replaced the old one, was tested by OIT from 30 July 14 to 6 Aug 14
Please insert your improvement Aim. You may include an overall aim and the individual aims for each of the work streams to which your team has committed.
Old Product
New Product

11. Storyboard Submission on 12-04-2015
25/5/2018
PDSA 2
Study:
The evaluation (full score: 7) of the product shows OITs are generally satisfied with the product except the drying effect. However, the compliance data didn’t show any improvement.
Please insert your improvement Aim. You may include an overall aim and the individual aims for each of the work streams to which your team has committed.
Act:
The new product was implemented although the intervention didn’t result in significant improvement in hand hygiene compliance

12. Storyboard Submission on 12-04-2015
25/5/2018
PDSA 3
Assumption:
It was presumed that because the product was new, they were not used to the product. If the vendor was invited to help train the OITs, this may improve the compliance rate.
Plan:
A training session was arranged with the trainer from the vendor company.
Do:
The training session was conducted in September 2014
Study:
No significant improvement in compliance rate was observed
Please insert your improvement Aim. You may include an overall aim and the individual aims for each of the work streams to which your team has committed.
Sample of Some Training Slides

13. Storyboard Submission on 12-04-2015
25/5/2018
PDSA 4
Assumption:
It was assumed at this point that the non compliance was more related to the process during the service provided for the patient.
Plan:
A short training video (approximately 90 seconds) was developed for process training.
Do:
The training session was conducted in Feb 2015
Study:
No significant improvement in compliance rate was observed
Please insert your improvement Aim. You may include an overall aim and the individual aims for each of the work streams to which your team has committed.

14. Control Chart of Compliance Rate
Process Training Intervention
Hand Hygiene Training by Vendor
In-house Hand Hygiene Training
New ABHR

15. What should we do next to improve compliance?
PDSA
Description
Status
PDSA 5
Redesign the visual field process to reduce the opportunities of hand hygiene
In “do”ing phase
PDSA 6
Patient triggered reminder
In “’plan”ning phase
PDSA 7
Hand rub sensor driven reminder device
Exploring the prototype of the device

16. Hand rub sensor driven reminder device
You get the final word. What did we leave out? What is important and missing? What would your team like to share or ask or express as a final word in this story board.

17. Final Word- Our Headline in 2016
Storyboard Submission on
25/5/2018
Final Word- Our Headline in 2016
To be the best rated Ophthalmic Ambulatory in Hand Hygiene Compliance among the Ambulatory Eye Centres
World Class in
Hand Hygiene
SNEC
You get the final word. What did we leave out? What is important and missing? What would your team like to share or ask or express as a final word in this story board.