Implementation Assessment: Quantitative Interview

Transcription

1 CUSP 4 MVP VAP Improving Care for Mechancially Ventilated Patients Implementation Assessment: Quantitative Interview ICU Unit Type: Hospital Name: Interview Date: Interviewer Name: Section 1: Staff Safety Assessment 1. How many of your staff members have viewed a video or presentation on the Science of Safety? Almost all / All One half or more Less than one half None / Few 2. Are you using either the Science of Safety video featuring Dr. Peter Pronovost or presentation slides, both developed at the Johns Hopkins Armstrong Institute? [PROCEED TO QUESTION 3] No [SKIP TO QUESTION 4] Don t know [SKIP TO QUESTION 4] We use a different presentation [PROCEED TO QUESTION 3] Do not use any safety presentation [SKIP TO QUESTION 4] 3. Is a patient safety presentation now part of your new staff or unit orientation for all patient care providers (e.g., physicians, nurses, respiratory therapists)? No, but preparing to do this No, with no current plans to do so Don t know Johns Hopkins IRB # NA_ Sean Berenholtz MD, MHS, FCCM PI

2 Section 2: Staff Safety Assessment 4. Have you conducted a safety assessment with your unit staff to identify potential safety risks in the unit? No [SKIP TO QUESTION 7] Don t know [SKIP TO QUESTION 7] 5. Are you using the two-question Staff Safety Assessment tool developed at the Johns Hopkins Armstrong Institute? (How will the next patient be harmed?) No Don t know 6. Have you grouped and prioritized the safety issues that emerged from the safety assessment you conducted with your staff? No Don t know Section 3: Implementation of The CUSP 4 MVP - VAP Bundle 7. The implementation process defined in the CUSP 4 MVP-VAP Toolkit lays out the following steps in implementing the bundle for ventilator-associated event (VAE) prevention. Please indicate whether you have taken each of these steps in your implementation process thus far. Yes No Don t Educate all staff on how to standardize as much as possible in the unit s setting using relevant protocols and educational tools. Improve communication among providers during the rounding process. Discuss spontaneous awakening (sedation vacation), spontaneous breathing trials (SAT and SBT), and/or sedation and delirium during the rounding process. Create independent redundancy or a double-check system so all patients receive the evidence based interventions they should for prevention of VAE. Implement interventions for early mobility (early ambulation). Implement interventions for low tidal volume ventilation. 2

3 Section 4: Implementation of CUSP 8. The CUSP process consists of implementing the following tools to improve teamwork and communication. Please indicate whether you have implemented any of these CUSP components in your VAE process thus far. Daily Goals Checklist Learning From Defects Tool Daily Briefing or Huddle for VAE prevention Patient safety culture survey (e.g., HSOPS, SAQ) Shadowing Barrier identification and mitigation for VAE prevention Structured communications (e.g., SBAR, ALEEN) Yes No Don t Section 5: Leadership Commitment and Support 9. Is your leadership team taking the following steps to reinforce its support for the work? Ensure training on the Science of Safety for all current and new employees. Meet with the team on the unit at least monthly. Make the CUSP 4 MVP-VAP project and VAE prevention an organization wide goal and coordinate this as part of the strategic institutional plan. Foster organizational learning by disseminating learning from-defects lessons and the CUSP team s successes across the hospital or institution. Provide protected time for any VAE prevention team leaders (physician, nurse, data collector). Engage the board by reporting quarterly on VAE performance data. Yes Somewhat No Don t 3

4 10. Hospital leaders: How actively engaged have the hospital leaders been with your CUSP 4 MVP- VAP project and VAE prevention? Actively engaged Moderately engaged Slightly engaged Not at all engaged 11. Unit leaders: How actively engaged have the unit leaders been with your CUSP 4 MVP-VAP project and VAE prevention? Actively engaged Moderately engaged Slightly engaged Not at all engaged Section 6: Data Review and Sharing 12. How often does the CUSP team take the following steps to review data on VAE rates and other performance data (e.g., process data, barriers faced), and share this information with other key stakeholders? Review the unit s CUSP 4 MVP-VAP data on VAE rates Share performance data (e.g., process data, assessment data, or barriers faced) broadly with unit staff (e.g., physicians, nurses, respiratory therapy, other staff) Present VAE rate data to senior hospital leadership Present other CUSP 4 MVP-VAP performance data to senior hospital leadership Present VAE rate data to board of directors/trustees Present other CUSP 4 MVP-VAP performance data to board of directors/trustees Yes, At Least Monthly Yes, Quarterly Yes, Annually No, Not At All Don t 4

5 Section 7: Barriers to Progress 13. In the past three months, how often did each of the following factors slow your CUSP 4 MVP- VAP team's progress in implementing the CUSP and VAE prevention interventions? Insufficient knowledge of evidence supporting interventions Leadership support issues Not enough leadership support from executives Not enough leadership support from physicians Never/ Rarely Occasionally Frequently Almost Always Not enough leadership support from nurses Insufficient autonomy/authority Team skills and cohesion issues Lack of quality improvement skills Confusion about how to proceed with CUSP activities Lack of team member consensus regarding goals Inability of team members to work together Turnover on CUSP team Stakeholder pushback issues Not enough buy-in from physician staff Not enough buy-in from nursing staff Not enough buy-in from other staff Workload and time issues Not enough time Staff turnover on unit Data collection burden for staff Problems with data systems Competing priorities or distractions (e.g., new electronic medical record, accreditation visit) 5

6 CUSP 4 MVP VAP Improving Care for Mechancially Ventilated Patients Implementation Assessment: Quantitative Interview ENGAGEMENT SCALE ICU Unit Type: Hospital Name: Interview Date: Interviewer Name: Purpose The purpose of this scale is to allow team leaders to quantify their assessments regarding how engaged their teams are in the process of implementing the CUSP 4 MVP-VAP bundle and CUSP components of the intervention. None Slight Moderate Positive Strong Little or no engagement Circle 1 if your team is not taking much action to implement the CUSP 4 MVP-VAP bundle or use CUSP to improve patient safety. 2. Slight engagement Circle 2 if your team is making some limited efforts to implement the CUSP 4 MVP-VAP bundle or use CUSP to improve patient safety, but NOT both. 3. Moderate engagement Circle 3 if your team is making some reasonable efforts to implement the CUSP 4 MVP- VAP bundle, OR use CUSP to improve patient safety, but NOT both. 4. Positive engagement Circle 4 if your team is making assertive efforts to implement the CUSP 4 MVP-VAP bundle, to use CUSP to improve patient safety, or both. 5. Strong engagement Circle 5 if your team is making very active efforts to implement the CUSP 4 MVP-VAP bundle AND use CUSP to improve patient safety, and are completely candid and forthcoming in discussing these efforts. 6