On the CUSP: STOP BSI
The Team Check-up Tool
© 2009
Learning Objectives
• To understand the tool we use to:
– Describe the anticipated activities of your ICU quality
improvement team
– Track implementation progress and the context of progress
– Assess barriers to progress
– Monitor interactions on the team
• To think about how the tool can be useful to you
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The Quality Improvement Team
• Core team working on the CUSP/ CLABSI project
• The small group that spreads the intervention to
the rest of the ICU
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Importance of the Quality
Improvement Team
• This team has the greatest impact on how the
intervention is “rolled out” at your site
(absolute power)
• Potential implications of a poor job
− Slower implementation
− Gaps/ uneven implementation
− Higher continued risk (infection, $, lives)
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TCT Measures:
• Engagement/ educational activities of the QI team
(on BSI and CUSP)
• Participation in CUSP activities
• Extent of implementation on unit
• Barriers to progress
• Interactions on team
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Team Activities-Keeping on Track
• Team meetings (recommend 2/mo)
• Review of data (monthly)
• Meet w/ Exec Partner on unit (monthly or more)
• Executive review of data (monthly)
• Presentations to the Hospital Leadership and
Board of Directors
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Education and Engagement
Activities on the Unit
• Modeling the line placement steps; stopping insertions that
violate protocol; having one-on-one talks where necessary
• CUSP Activities
− Science of safety video
− How will we harm the next patient? exercise
− Daily Goals
− Morning Briefing
− Learning from a defect
− Executive Partnership
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Education and Engagement
Activities on the Unit
• More Activities (add your ideas!)
− Internal seminar for staff
− Present project at all committee meetings
− Make BSI prevention part of a skills fair
− Have IC dept visit/ give a talk
− In-services/ demos
− New written policy
− Post the steps and progress updates
− Put the prevention practices on all clipboards
− Update/ prepare line cart/ kit with checklist
− Hand out Fast Facts one-page info sheet
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Barriers to Progress
• Turnover on QI Team
• Spread to other parts of the hospital
• Disruptive events
• Lack of skills
• Lack of time
• Lack of buy-in
• Lack of support
• Lack of autonomy
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Interactions among
Team Members
• Team agrees on goals
• Team values individual contributions
• Team can resolve conflicts
• Team is unified
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Action Items
• Look over the tool
• Think about what elements are most important to watch
• Share TCT data with executive partner
• Make a strategic plan to address identified barriers early
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Reference List
•
Lubomski, Lisa H., Jill A. Marsteller, Yea-Jen Hsu, Christine A. Goeschel, Christine
G. Holzmueller, and Peter J. Pronovost, “The Team Checkup Tool: Evaluating
Quality Improvement Team Activities and Giving Feedback to Senior
Leaders,” Joint Commission Journal of Quality and Patient Safety, October
2008.
•
Marsteller, Jill A., Christine G. Holzmueller, Martin Makary, J. Bryan Sexton,
David Thompson, Lisa H. Lubomski and Peter J. Pronovost. “Developing
Process-Support Tools for Patient Safety: Finding the Balance Between Validity
and Feasibility,“ Joint Commission Journal of Quality and Patient Safety,
October 2008.
© 2009