Convene a Vascular Access Committee to review PICC use and outcomes on a monthly to quarterly basis
Numerous studies suggest audit and feedback of data related to utilization and outcomes of central lines (including PICCs) to frontline clinicians improves outcomes
A multi-disciplinary team consisting of key stakeholders that includes (but is not limited to), organizational leadership (e.g., CMO, CQO, CNO), vascular access team members, interventional radiology, critical care physicians, hematology/oncology physicians, emergency room physicians and hospitalists is suggested for maximal impact
The multidisciplinary team should meet quarterly, identify opportunities for improvement (e.g., PICC use <5 days) by reviewing HMS data and outline strategies, resource requirements and next steps for implementing change.
The team should follow the impact of their interventions using both local and HMS data to fully understand barriers, facilitators and outcomes affected as a result of the changes made or workflow improvements performed.
Designate an internal facilitator for all PICC-related QI efforts. The internal facilitator may be a member of the Vascular Access Committee but focuses their work on implementing changes recommended from the committee. The internal facilitator will work with the coordinating center to identify barriers and facilitators in implementing PICC QI efforts
Designate a physician champion to assist with PICC initiatives. The physician champion should work closely with the vascular access team and HMS PICC abstractor to facilitate changes and support initiatives throughout the project.
To achieve results in wider contexts: recruit advocates within the organization, keep the team focused on goals, create an alliance with central administration to secure resources, shift power relations, create social and reputational incentives for cooperating, open channels of communications with units that face the same challenges, and use audit and feedback.
This model uses a systems engineering model to identify the types of factors, barriers and facilitators to consider when implementing a change or improvement process. The model identifies technologies, tools, environment, people and the work environment as key components for a Vascular Access Committee to consider.
The addition of a highly Partnered Implementation Facilitation strategy to national level support resulted in greater Reach and Adoption of the mandated PC-MHI initiative, thereby increasing patient access to VA mental health care.