1. The Team Check-up Tool

2. Slide 2 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

3. Slide 3 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

4. Slide 4 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)

5. Slide 5 TCT Measures: Engagement/ educational activities of the QI team (on BSI and CUSP) Participation in CUSP program activities Extent of implementation on unit Barriers to progress Interactions on team

6. Slide 6 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

7. Slide 7 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

8. Slide 8 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

9. Slide 9 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

10. Slide 10 Interactions among Team Members Team agrees on goals Team values individual contributions Team can resolve conflicts Team is unified

11. Slide 11 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

12. Slide 12 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.