In April 2008 we were approached by one of our clients to begin developing a hygiene code compliance tool for use within the NHS.

During development a number of NHS trusts were trialling the system and providing feedback, suggestions and features to improve the system. Now, more than 18 months later, the infection control audit software has been further developed and is now being used by approximately 20 NHS trusts.

The developers

The system was developed in-house by Andy Reading under the guidance of David Miller and John Horton of Klarient Limited.

Klarient is a business-focussed IT consultancy, which provide management and technical consultancy services with a particular focus on Identity and Access Management (IAM) and Audit and Compliance solutions.

Klarient provide services to both the private and public sectors and have in-depth experience in healthcare sector at local and national levels.

Find out more about Klarient’s identity and access management solutions and infection control software.

The Hygiene Compliance Software

Named Saving Lives, the system is an easy to use web-based tool which allows health organisations to record and manage their compliance with the Hygiene Code.

Its core features are:

• Simple and intuitive interface
• Accessible from any PC with a web browser and internet access
• Clear and easy navigation for users to enter self-assessment scores, actions, progress updates and produce reports based on this data
• Links to local documents, such as policies or surveillance data, to provide supporting evidence
• Simple traffic light system highlights priority areas
• Clear graphical trend reporting showing improvements over time
• Detailed action reports showing all actions, status and progress
• An audit trail of all updates

What the users think…

Darren Nelson, Infection Prevention and Control Service Manager, Imperial College Healthcare NHS Trust:

We found the web-based tool really easy to use and really like the way we can cut data and reports and drill down, very helpful. The key thing for us is the time it saves.

Whenever required we can pull off the latest reports at the required level of detail for the Trust Infection Control Committee, the Infection Control Team Meeting or the Exec. Team.

Vanessa Whatley, Lead Nurse Infection Control, Royal Wolverhampton Hospitals NHS Trust:

As you know we are using the tool ‘in anger’ now. I must say how easy it is to keep the action plan up to date and access the system. The format of the system is straightforward and uncomplicated, enables frequent update of the action plan and withdrawal of information for reports.

Shared access to the system to update the plan and access the current situation has the potential to save a considerable amount of time, keep to timescales and share ownership.

Evaluation version

An evaluation version of the software is available at the hygiene code compliance tool website.

Screenshots

Main compliance criteria listing page:

Implementation Guidance data entry screen:

Export update history log:

Compliance Criteria summary reports:

Compliance criteria summary reports (PDF version):

Actions by date report:

User administration:

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Our system allows the client to create/edit/delete categories and sub categories to help organise the documents. Previously they would have had to create a new page with Microsoft Frontpage and then modify other pages to insert appropriate links to it.

With our easy to use admin system our client can now navigate through their category structure, quickly edit or delete categories and also add new ones. Previously this was a very time consuming task and as a result the system was infrequently maintained.

Adding documents to the system requires you to fill in a short form and select a document to upload. The system allows storing of documents in multiple categories and have multiple related documents. These documents can be “tagged” with custom key words that are searchable in addition to the title and descriptions of the document. This can be extremely useful in helping users find files. In addition, certain information is automatically detected such as file size, type and date uploaded, all of these can be used to order search results.

Other features include featured documents which appear on the home page for all users to see, most popular or recently uploaded documents, document relevance to help find only the documents relevent to your part of the company, and much more…

We plan on expanding this system to include many more features and enhanced functionality such as version control for multiple users, and even user workgroups where certain users can share and track files that are not publicly available. Of course, with all our applications they are bespoke and can be altered or new features added to suit your exact needs.

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In the past we’ve had several clients say:

“That text would look much neater justified, can you change it please?”

In most cases we’ve successfully explained the pitfalls of justified text and the client has agreed to keep the standard left alignment. However, in some cases, clients had decided to have justified text regardless.

What is justified text and when is it used?

Justified text or justification, in typography, is the alignment of text within a column or measure to align against the left and right margin. To achieve this effect, extra space is added between words. Justified text is commonly used in printed media such as newspapers, book, leaflets etc where the straight line on each margin can be used successfully to guide the eye across columns of text.

Newspapers are a great example of  justified text used successfully. With such a large amount of information to place on a large area, the neatly aligned columns clearly define the different areas of text and create a logical flow of words, thus enhancing readability.

Why is justified text on websites a bad idea?

There are many reasons why not to use justified text and they revolve around usability and user experience.

The human eye perceives images on a screen different to that of printed media so its understandable that justified text can work, but not necessarily on a computer screen. You may not be aware but the image on a screen is not static, in fact its updated and refreshed many times a second. Reading on a computer screen is much harder on the eyes than reading from printed media.

Here are the top reasons why justified text is a bad idea for websites

• When using justified text for print, the designer has complete control over how the user will see the content. However, with the many combination of website browsers (and versions) on many different operating systems, a website designer can not be certain how the justified text will be rendered on the screen. For example a person using Firefox 3 browser on a Mac, would likely see the text displayed differently to somebody using Internet Explorer 6 on Windows XP.
• The different rendering on different systems can create “rivers” of white space. This is when the spaces between words line up with other lines of text, creating a column of space down the content. This river within the text draws the eye away from the content making it more difficult to read. In some cases the white space can form more of a logical pattern than the content itself.
• A combination of the first two points make justified text difficult to read by dyslexic users. The uneven white space creates a distraction which can easily make you loose your place. As web designers we spend time testing in different browsers to make sure as many people as possible can view the website as intended. Around 10% of the UK population are affected by dyslexia to some degree, so making a website that is difficult for 10% of users to read is obviously a bad idea!
• Visually impaired users often use screen magnifiers to enlarge text to a suitable level. Many magnifiers work by enlarging the area around your mouse. Because the large uneven spaces are also magnified it can become difficult for the to follow the words with their magnifying software. Instead of following the flow of words along even spacing, users have to find the start of each new word.
• The Royal National Institute of Blind people (RNIB) strongly recommend websites do not use justified text. Modern websites are all about the user. There was a time websites were created to look good on the creators screen, not necessarily other users. Websites we not tested thoroughly to make sure all users can access the content. Times have changed and accessibility and usability are very important factors in modern website development. Doing anything that excludes or hinders certain users, reduces the audience and therefore the overall success of a website.

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