1. CUSP 4 MVP – VAP Exposure Receipt Assessment 1: Aggregated Results (Cohort 1) Kisha Ali, MS Roshanak Hakimian October 8, 2014

2. Exposure Receipt Assessment Metric designed to close the gap between hospital unit leads and frontline providers Purpose is to help identify and work with teams to provide needed training, resources, or other aids Pioneered in the CUSP for VAP Maryland and Pennsylvania Pilot Project– paper based Evolved for CUSP4MVP-VAP – now electronic, questions reflect most updated evidence for VAE prevention 2

3. Exposure Receipt Assessment Metric allows the implementation components of the project to be quantified Data provided directly by front-line staff with direct-patient care In congruence with the Implementation Assessment - tools are complementary Assessment –consist of solely quantitative questions –Anonymous –Semi-annual Supports improvement efforts of individual units 3

4. Unit Participation: Results of Compliance Participation Overall: -Aggregated results from Cohort 1 -Administered 3 months into the project (May – Jun 2014) -593 observations -7 states Participation by State: 4 Coordinating Entity (n= # of units) Number of Front-line Staff that Completed ERA Contribution to Result Data (%) UHC (n= 2)9015.18 MHA Keystone (n=19)20133.91 Texas (n= 7)15726.48 New Jersey (n=13)7612.82 Tennessee (n = 9)6911.64 South Carolina (n= 6)00 Independent (n= 1)00

5. Exposure Receipt Assessment Measures 5 Results divided into 3 categories based on question type to allow similar components to be examined together. The categorical measures are as follows: 1.Distribution of participants 2.CUSP Components of the intervention 3.MVP-VAP Components of the intervention

6. Distribution of Participants What is your role in the Unit? 6 Percentage of Units

7. CUSP Components of the Intervention How familiar are you with CUSP? 7 Percentage of Units

8. CUSP Components of the Intervention Do you have a CUSP team on your unit? Has CUSP been active at improving patient safety? 8 Percentage of Units

9. CUSP Components of the Intervention Have you watched a Science of Safety presentation Have you completed a Staff Safety Assessment 9 Percentage of Units

10. CUSP Components of the Intervention Have you used the Learning from Defects tool? For how many patients has your unit used Daily Goals? 10

11. Summary: CUSP Components of the Intervention The majority of units participating in Cohort 1 are familiar with CUSP Half the units have CUSP teams, but only 50% of those teams are active, and even less are using all the CUSP tools Overall, providers believe that these teams are somewhat active at improving patient safety. Penetrance and use of the tools, Staff Safety Assessment and Science of Safety, are high Penetrance and use of the tools, Learning from Defects and Daily Goals, are low 11

12. MVP - VAP Components of the Intervention 12 Do you know your unit’s VAP or VAE rate(s)?

13. MVP - VAP Components of the Intervention 13 Which of these interventions are being used by your Unit and how often? Percentage of Units

14. MVP - VAP Components of the Intervention 14 Do you believe that the interventions in MVP-VAP bundle will help to prevent VAE on your Unit? Percentage of Units

15. MVP - VAP Components of the Intervention 15 In your opinion, which of the following interventions are most likely to prevent VAE? (Select 3) Percentage of Units

16. MVP - VAP Components of the Intervention 16 In your opinion, where is the biggest opportunity to improve care of mechanically ventilated patients in your unit? Percentage of Units

17. Summary: VAP Components of the Intervention Overwhelming proportion of front-line providers believe the technical interventions prevent VAE Most front-line staff know their VAE rates All 6 MVP-VAP bundle interventions measured are being used at least 50% of the time Providers believe early mobility represents the biggest opportunity to improve care for MVP 17

18. Conclusion Results represent the perspective of 593 front-line clinicians surveyed in the Exposure Receipt Assessment 1 for Cohort 1 Units will soon be able to track implementation successes and barriers over time via CECity platform Assessments will continue to be administered semi-annually –Next ERA assessment will be administered Nov. 2014 This assessment helps identify –Additional opportunities for education and training on the unit –Bridges the gap in information –Areas of success Remember to involve your font-line staff in the CUSP4MVP-VAP project 18

19. Thank you! Questions? 19