MHA Keystone Center for
Patient Safety & Quality
Chris George, RN MS
Project Manager, MHA Keystone Center
cgeorge@mha.org
517-886-8404
www.mhakeystonecenter.org
Jill A. Marsteller, PhD, MPP
Assistant Professor, Dept. of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
jmarstel@jhsph.edu
410-614-2602
Session Objectives
At the conclusion of the webinar, participants
will:
– Understand the purpose of completing the
Monthly Team Check-up Tool (MTCT)
– Understand how to enter the MTCT into Care
Counts
– Have an awareness of reports that are available to
them in Care Counts
– Know how to access help using the system
Purpose of MTCT
Purpose
• Helps to monitor progress of CUSP steps and
CLABSI reduction steps
• Identifies activities of teams and elements of
team context that influence performance
• Helps identify barriers in teamwork and
communication to guide corrective action
Why do we use the MTCT?
• Variability in site performance
• Need for information about what’s going on onsite
• Have/how have other collaboratives monitored
progress and context?
• Testing the MTCT
– Good reliability (temporal stability); good responsiveness;
construct validity was demonstrated; tool demonstrated
convergent and divergent validity of the MTCT barriers
• Focus groups about the MTCT
TCT and Successful CQI Implementation

Five months of Keystone data, Mar-Jul 05
More frequent senior executive meeting was
associated with lower CLABSI rates (IRR=0.76,
p<0.001).
 Not enough leadership support from executives
was associated high CLABSI rates (IRR=2.84,
p=0.001)
 Inability to work together was associated with
higher CLABSI rates (IRR=3.11, p=0.037)

TCT and Successful CQI Implementation

Adventist data, Mar 07 - Feb 08
Educational activity “infection control visit/talk”
was associated with higher CLASBI rates
(IRR=2.44, p=0.012)
 Appropriate hand hygiene was associated with
lower CLABSI rates (IRR=0.41, p=0.019)

TCT and Successful CQI Implementation

Adventist data, Mar 07 - Sep 08

ICU teams with a majority of TCTs reporting work
distractions were less likely to perform full-barrier
precautions (coef.=-0.13, p=0.034) and remove
unnecessary lines (coef.=-0.14, p=0.009)
Key Points: MTCT Completion
• The team leader completes the tool
monthly ideally with input from the team at
a team meeting or individual conversations
with team members
• Answers to MTCT questions are based on
previous month’s experience
• Use a separate MTCT for each unit
participating in the hospital
Care Counts Log-In Screen
www.mhacarecounts.org
If you forget your
password, click on Forgot
your Password. You will
need to know your
username. If you need
help, contact Nicole Smith
(nsmith@mha.org) or 517886-8437.
Change Password and Data Entry
ICU Home Page
Select Team Check-Up National
Select Correct Unit
Verify Month and Year
Select Team Activities
Compliance with Checklist
Learning from Defect Activity
Barriers and Spread
Team Cohesiveness
Error Messages
You must answer the
questions marked
with an error icon
before the data will
be accepted.
Click Save when you have
answered the questions
marked with an error icon.
Data Successfully Saved
If data is saved
successfully, you will
automatically be returned to
the data entry screen.
Running Reports
Select Unit
Select Timeframe
Some Reports Allow Roll-up Feature
Reports Are Exportable
Exporting to excel
allows you to work with
the data. PDF creates
a printer friendly view
Monthly Team Check-Up Tool Common Barrier and Team
Activity Report Examples and Descriptions
Note: Common Barriers are included in these reports when teams answer
“yes” or “to some extent” as to whether those issues were a barrier
that month
Report Name: Common Barriers
Description: Reports the percentage of time each category was seen as
a barrier to team progress
• Use this report to:
– View barriers for a specific time period (e.g. last quarter of 2009)
– View barriers by individual unit or select specific units and roll-up data
Common Barrier Report
Barriers Over Time Description
Report Name: Common Barriers to Team Progress Over Time
Description: Reports the percentage of time each category was
seen as a barrier to team progress with comparison to the
sponsor (state collaborative) or peer group
• Use this report to:
– View barriers for an individual unit over several months
– Compare barriers to those reported by a peer group or your sponsor (state
collaborative)
Barriers Over Time Report
Barriers to Progress One Time Period
Report Name: Common Barriers to Team Progress One Time Period
Description: Reports the percentage of time each category was seen as a
barrier to team progress with comparisons to a peer group or sponsor
(state collaborative) data during a specified timeframe
• Use this report to:
– View barriers for an individual unit for multiple months at a time (example: view one
quarter as a single data point)
– Compare barriers to those reported by a peer group or your sponsor (state collaborative)
data for the same time period
Barriers One Time Period
Team Activities Report Desc.
Report Name: Team Activities
Description: Reports monthly team check-up data, can be rolled up for
multiple months at a time and can be rolled-up for multiple units at
a time
• Use this report to:
– View several months of completed Monthly Team Check-Up Tools by individual units at
one time to see progressions in activities, how often meetings are being held, and data
is being shared etc.
– View roll-up information for multiple units over several months to see a summary of
activities taking place. In a roll-up of units, you will see a percentage of how many
units reported each individual barrier to be an issue. Roll-up data can be useful for
situations where there are multiple units participating, but should be used with
caution as there can be tremendous variation between unit activities even with the
same executive sponsor.
Team Activities Report
Team Activities, cont’d
Team Activities, cont’d
Team Dynamics
Viewing Multiple Units Description
Report Name: Team Activities-One Month-Multiple Units
Description: Shows data for multiple units for a one
month timeframe
• Use this report to:
– View multiple units in a hospital or system on a monthly basis instead of
viewing each individual report in Care Counts
Viewing Multiple Units Report
Questions?