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Building Your CUSP Team Part I. Michael Rosen , PhD August 28, 2012 Armstrong Institute for Patient Safety and Quality Conference Number(s): 800-779-9891 Participant Code: 4757941. On Boarding Call Schedule – Tuesdays 8/21–9/25 @ 2:00.

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building your cusp team part i

Building Your CUSP Team Part I

Michael Rosen , PhD

August 28, 2012

Armstrong Institute for Patient Safety and Quality

Conference Number(s):800-779-9891

Participant Code:4757941

on boarding call schedule tuesdays 8 21 9 25 @ 2 00
On Boarding Call Schedule –Tuesdays 8/21–9/25 @ 2:00

CUSP Comprehensive Unit Based Safety Program; VAP Ventilator Associated Pneumonia

Program Introduction August 21, 2012

Building CUSP team – August 28, 2012

Science of Safety – September 4, 2012

CUSP Part 2 – September 11, 2012

VAP Evidence – September 18,2012

Daily Goals Review – September 25, 2012

Early Ambulation– August /30/2012

learning objectives
Learning Objectives
  • Describe the importance of your CUSP team
  • Develop a strategy to build a successful team
  • Define roles and responsibilities of team members
  • Identify characteristics of successful teams and barriers to team performance
the armstrong institute model to improve care
The Armstrong Institute Model to Improve Care

Translating Evidence Into Practice

(TRiP)

Eliminating Ventilator Associate Pneumonia

Comprehensive Unit based Safety Program (CUSP)

  • Summarize the evidence
  • Identify local barriers to implementation
  • Measure performance
  • Ensure all patients get the evidence
    • Engage
    • Educate
    • Execute
    • Evaluate
  • Emerging Evidence
  • Local Opportunities to Improve
  • Collaborative learning

Educate staff on science of safety

Identify defects

Recruit executive to adopt unit

Learn from one defect per quarter

Implement teamwork tools

Technical Work

Adaptive Work

http://www.hopkinsmedicine.org/armstrong_institute

the cusp team
The CUSP Team
  • Understands that patient safety culture is local
  • Composed of engaged frontline providers who take ownership of patient safety
  • Includes staff members who have different levels of experience and perspectives
  • Meets regularly (weekly or at least monthly)
  • Has adequate resources including protected time
    • 2 to 4 hours per week for a team leader, surgeon, anesthesia, nurse, and infection preventionist
team performance
Team Performance
  • Inputs
  • Environment
  • Hospital & Unit Context
  • Team Composition
  • Task Design
  • Outputs
  • Performance
  • Attitudes
  • Behaviors
  • Processes
  • Inside Team
  • Outside Team
  • Team Traits
cusp team members
CUSP Team Members
  • Physician champion
  • Nurse champion
  • Project lead/ unit champion
  • Respiratory Therapist
  • Infection Control
  • Executive Partner
  • Frontline staff
  • Nurse Educator
  • ICU Nurse Manager
  • Pharmacist
  • Hospital Patient Safety
  • Chief Quality Officer
  • Staff from Safety, Quality or Risk Mgmt Office
team composition
Team Composition
  • A team leader
  • Champions (nurse and physician)
  • Local “opinion leaders”
  • People with diverse opinions
team composition1
Team Composition
  • Someone outgoing
  • Someone who sees the big picture
  • Someone detail-oriented
  • Everyone dedicated
successful teams have
Successful teams have…
  • Reliable Processes
    • Education and engagement activities
    • Communication
    • Leadership support/buy-in
    • Conflict (and conflict resolution)
successful teams have cont
Successful teams have…(cont.)
  • Norms
    • Valuing individual contributions
    • Cohesion (team unity)
    • Goal agreement
    • Self-assessment of knowledge /skills
    • Participation of team members
  • Role clarity
engage core cusp team members
Engage Core CUSP Team Members
  • Physician champion
  • Nurse champion
  • Project lead/ unit champion
  • Respiratory Therapist
  • Infection Control
  • Executive Partner
  • Frontline staff
  • Nurse Educator
  • ICU Nurse Manager
  • Pharmacist
  • Hospital Patient Safety
  • Chief Quality Officer
  • Staff from Safety, Quality or Risk Mgmt Office
tips for engaging physicians on the cusp team
Tips for Engaging Physicians on the CUSP Team
  • Identify physician leaders
  • Create a forum for this role
  • Listen to physician concerns
  • Develop plans to address concerns
  • Reward physician leaders
  • Create a vehicle for communication
  • Develop a plan for communications
physician engagement strategies
Physician Engagement Strategies
  • Create a Compact (an Agreement) with management
    • Clearly define what is expected of physicians
    • Review performance regularly
example physician champion compact
Example Physician Champion Compact
  • Hospital will provide support for percent of physicians’ time
  • In return, physician will do the following:
    • Monitor and improve quality
      • Implement CUSP and VAP interventions
      • Hold regular meetings with team
      • Involve other members of Medical staff in quality
      • Report VAP rates and learning from defects results to senior leaders and board
example physician champion compact1
Example Physician Champion Compact
  • Further, physician will do the following:
    • Work with hospital to clarify what will be measured, who will measure it, and who will produce reports
  • Meet quarterly to discuss progress
tips for scheduling your meetings
Tips for Scheduling Your Meetings
  • Incorporate CUSP meetings into ongoing educational activities to ease scheduling challenges
    • Regularly scheduled nurse training
    • Grand rounds for physicians
    • Invite RNs to joint grand rounds
  • Create incentives for participating
    • Educational credit for participation
action items
Action Items
  • Form your team with an appreciation of the importance of WHO is on the team
  • Complete the CUSP Team Membership Form
  • Plan to attend Part II of Building your CUSP Team
slide22

Questions or Comments?

Armstrong Institute for Patient Safety and Quality

contacts
Contacts
  • Karol G. Wicker, MHS

Senior Director, Quality Policy & Advocacy

Maryland Hospital Association

kwicker@mhaonline.org

  • Mary Catanzaro RN BSMT CIC

Project Manager HAIs

Hospital and Healthsystem Association of Pennsylvania

mcatanzaro@haponline.org