CUSP 4 MVP – VAP Improving Care for Mechanically Ventilated Patients Implementation Assessment...

CUSP 4 MVP – VAPImproving Care for Mechanically Ventilated Patients

Implementation AssessmentKisha Ali, MS

May 13, 2015

ARMSTRONG INSTITUTE FOR PATIENT SAFETY AND QUALITY

Johns Hopkins University

2 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients

Implementation Assessment1 (IA)

• ICU collaborative developed the Team Checkup Tool (TCT) in 2005 during the MHA Keystone

• Designed to close the gap between hospital executives, hospital leaders, unit leaders and frontline teams by providing dynamic feedback during the implementation phase

• Identify and work with teams to provide needed training, resources, or other aids

• Evolved for CUSP4MVP-VAP – now electronic, questions reflect most updated evidence for VAE prevention


Implementation Assessment2

• Measures components and contextual factors that affect quality improvement initiatives

• Quantifies the implementation components of CUSP and MVP–VAP

• Consists of quantitative and qualitative sections

• Complete quantitative section online via the CECity platform

• Random subset of participants complete the open-ended qualitative section via telephone


How It Works

• Data provided directly by project unit lead

• Utilized in congruence with complimentary tools

Exposure Receipt Assessment

Structural Assessment

• Implementation Assessment Tool

Completed by project unit lead semi-annually

Quantitative: ~15 minutes online

Qualitative: ~30 minutes via telephone


Implementation Assessment1

Tool

Aggregated Quantitative IA Results focuses on 8 measures:

1. Training on patient safety

2. Staff Safety Assessment

3. Implementation of the CUSP4MVP-VAP bundle

4. Implementation of CUSP

5. Leadership commitment and support

6. Data review and sharing

7. Barriers to progress

8. Team engagement

6 CUSP 4 MVP – VAP: Improving Care for Mechanically Ventilated Patients6

Cohort 1 - Data Summary

• IA Administration

Cycle 1: 05/01/2014 - 08/31/2014

Cycle 2: 11/03/2014 - 02/28/2015

Cycle 3: 05/01/2015 – 07/31/2015

• IA Cycle 3 for Cohort 1 is now open for completion by CUSP4MVP-VAP unit lead

• The following data illustrates the results of cycles 1 & 2 to show what’s available on the CECity Platform to teams regarding:

Unit-level Data

Peer-comparators at the CE level

Peer-comparators at the Cohort level


Example of Results – Section 1

7


Example - Section 7Barriers to Progress

In the past 3 months, how often did each of the following factors slow your team's progress in implementing CUSP and VAE prevention interventions?

5 major overarching barriers to progress are identified and can be addressed

18 unit-specific barriers to progress are identified and can be addressed

BARRIER GROUPNUMBER OF POSSIBLE BARRIERS

Insufficient knowledge of evidence 1

Leadership support issues 4

Team skills and cohesion issues 5

Stakeholder push‐back issues 3

Workload and time issues 5


Accessing the Quantitative IA on CECity

1. Log-in to the CECity platform

2. Select “Portal Home”

3. Select the “CUSP4MVP-VAP” app



1. Go to “My Tools”

2. Search for your unit by name

3. Select “CUSP4MVP-VAP”



1. On the Implementation Assessment app, select “Manage”



1. Select the “Cycle” you would like to complete

2. Select the “Assessment” tab to complete the IA

3. Select the “Reports” tab to view your IA results


Ways the Implementation Assessment Can Assist You

• This assessment identifies

Additional education and training needs, both on your unit and within cohort

Barriers to progress

Opportunities for improvement

Areas of success

• Using the IA results, units can track their implementation and contextual successes and barriers, as well as compare progress with peers

• A sample of units that complete the quantitative portion will be contacted to complete the qualitative portion

• Cycle 3 of the Quantitative Implementation Assessment should be completed by July 31, 2015


References

1. Lubomski LH, Marsteller JA, Hsu YJ, Goeschel CA, Holzmueller CG, Pronovost PJ. Team checkup tool: evaluating qi team activities and giving feedback to senior leaders. Jt Comm J Qual Patient Saf. 2008; 34(10): 619-623. PMID: 18947123.

2. Ali KJ, Farley DO, Speck K, Catanzaro M, Wicker K, Berenholtz SM. Measurement of implementation components and contextual factors in a two-state healthcare quality initiative to reduce ventilator-associated pneumonia. Infect Control Hosp Epidemiol. 2014; 35: S116-23. PMID: 25222890.


Thank you!

CUSP 4 MVP – VAP Improving Care for Mechanically Ventilated Patients Implementation Assessment...

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