Results of Quarterly Team Update Interviews Kisha Ali, MS Donna Farley, PhD, MPH August 8, 2013.

Results of Quarterly Team Update Interviews Kisha Ali, MSDonna Farley, PhD, MPH

August 8, 2013

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Quarterly Team Update Tool1

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

• Designed to close the gap between hospital executives and frontline teams

• Purpose is to help collaborative or project, hospital, and team leaders identify and work with teams to provide needed training, resources, or other aids

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Quarterly Team Update Tool

Quantitative results focused on 4 measures:

1. Training on patient safety

2. Implementation of CUSP tools

3. Leadership commitment and support

4. Barriers to progress

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Measure 1. Training on Patient Safety

• Question 1: Since you began participating in the project, how many of your staff have viewed a video or presentation on the science of safety?

- None/few - Less than one half- One half or more - Almost all/All

• Question 3: Is a patient safety presentation now part of new staff orientation for your unit? - Yes/No

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Measure 1: Results from Training on Patient Safety

Fig 1. Percentage Distribution by Number of Patient Safety Training Actions Taken

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Measure 2: Implementation of CUSP Tools

• Question 18: What CUSP tools are you implementing?

• Responses: - Shadowing - Morning briefings

- Daily goals checklist- Culture checkup tool

- Learning from defects tool- Barrier identification and mitigation- Observing rounds (fly on the wall)- Structured communications

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Measure 2: Results fromImplementation of CUSP Tools

Fig 2. Percentage Distribution by the Number of CUSP Tools Used

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Measure 3: Leadership Commitment and Support

• Question 21: Is the organizational leadership taking the following steps to reinforce its support for the work?

• Checklist items: 1. Ensures training on science of safety 2. Monthly meeting with VAP team

3. Makes EVAP an organization-wide goal4. Disseminating learning from defects lessons

5. Provides protected time to VAP team leaders6. Reviews VAP rates quarterly at board meetings

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Measure 3: Results from Leadership Commitment and Support

Fig 3. Percentage Distribution by the Number of Leadership Support Actions Taken

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Measure 4: Barriers to Progress

• Question 29: In the past 6 months, how often did each of the following slow your CUSP team’s progress in implementing the CUSP and VAP interventions?

• Responses classified into 4 categories: 1. Leadership support issues2. Team skills and cohesion issues3. Stakeholder push‐back issues4. Workload and time issues

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Measure 4: Results from Barriers to Progress

Fig 4. Percentage Distribution by the Number of Barriers Reported as Frequent or Always

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Measure 4: Results from Barriers to Progress

Fig 5. Barriers Reported as Being Frequent or Always

All units (N=43) MD units (N=23) PA units (N=20)

Barrier Percent of Units Barrier Percent

of Units Barrier Percent of Units

Competing priorities 58.1 Competing priorities 47.8 Competing priorities 70.0

Data collection burden 48.8 Data collection burden 43.5 Data collection burden 55.0

Not enough time 39.5 Not enough time 39.1 Staff turnover on unit 45.0

Data system problems 32.6 Data system problems 26.1 Confusion on CUSP 40.0

Staff turnover on unit 27.9 Leader support - exec 13.0 Not enough time 40.0

Leader support - MDs 18.6 Leader support - MDs 13.0 Data system problems 40.0

Confusion on CUSP 18.6 Staff turnover on unit 13.0 Leader support - MDs 25.0

Poor buyin- MD staff 16.3 Knowledge of evidence 8.7 Turnover CUSP team 25.0

Turnover CUSP team 14.0 Poor buyin- MD staff 8.7 Poor buyin- MD staff 25.0

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Measure 4: Results from Barriers to Progress

Fig 6. Areas of Success - Lack of Barriers Reported as Being Frequent or Always

All units (N=43) MD units (N=23) PA units (N=20)

Barrier Percent of Units Barrier Percent of

Units Barrier Percent of Units

Lack team agree on goals 2.3 Turnover CUSP team 0.0 Poor team teamwork 0.0

Poor buy-in - nurse staff 2.3 Poor buy-in - nurse staff 0.0 Poor buy-in - nurse staff 5.0

Poor team teamwork 4.7 Leader support - nurses 0.0 Leader support - nurses 5.0

Knowledge of evidence 4.7 Little autonomy 0.0 Lack QI skills 5.0

Leader support - nurses 4.7 Lack QI skills 0.0 Leader support - exec 10.0

Lack QI skills 7.0 Confusion on CUSP 0.0 Little autonomy 10.0

Little autonomy 9.3 Poor team teamwork 4.3 Poor buy-in - other staff 15.0

Poor buy-in - other staff 9.3 Poor buy-in - other staff 4.3 Knowledge of evidence 15.0

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Conclusion

• Currently we have conducted 43 Quarter 1 interviews

• Process works well• Yet to begin our qualitative analysis of these

interviews – should yield interesting results• As we move forward, more Quarter 1 reports

being scheduled, as we move into Q2 interviews

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Reference

1. Lubomski LH, Marsteller JA, Hsu YJ, et al. The Team Checkup Tool: Evaluating QI Team Activities and Giving Feedback to Senior Leaders. Joint Comm J Qual Pt Safety. 2008; 34(10): 619-623.