Needs/Resource Assessment
Survey previous or ongoing efforts and resources
In many ways your multidisciplinary team is building, flying, and navigating an aircraft that is already airborne. Therefore it pays to know exactly what you have going for you. Experience, precedents, or resources at your institution can really lift your effort. Conversely, you’ll want to avoid working at odds with infrastructure or strategic goals that are already set.
Each of the items below could affect your approach to this improvement effort. Now is the time, especially for the team leader, to get a read on these things. They can influence your performance tracking system and interventions. If your team cannot answer one of these questions, make sure to enlist (or at least interview) someone who can.
- What is our existing quality improvement infrastructure? What kind of support or services can they provide to this project?
- Are there any ongoing quality improvement initiatives to learn from or leverage?
- Are there any initiatives that could influence support for a VTE prevention effort: e.g. pursuit of Magnet Recognition, Ventilator Associated Pneumonia bundle, Surgical Care Improvement Project (SCIP), interest in TJC/NQF proposed core measures
- Do we have any performance data on VTE prevention or VTE events?
- Are there any major lessons from previous or ongoing interventions to prevent VTE?
- How successful were previous VTE risk assessments and why? Were they integrated into order sets?
- Do we have any ongoing VTE awareness or educational activities for medical staff?
- Do we have policies capable of enforcing provider performance of anything, e.g. medication reconciliation, vaccinations, VTE prophylaxis, etc?
- How fragmented is care in our hospital? Are ICUs open or closed? How well do we geographically cohort our patients by service/specialty?
- Do we have any existing practices for standardizing care transitions between settings, e.g. medication reconciliation, communication strategies?
- Can we leverage any precedent for engaging patients in promoting medical staff accountability for any specific care goals?
- In what areas of the hospital are nurses engaged in promoting medical staff accountability for any specific care goals, e.g. daily goals worksheet, participation in multidisciplinary rounds?
- Can we expand the role of our clinical pharmacists in care delivery beyond traditional activities, e.g. participation in multidisciplinary rounds, pharmacokinetics consults, pages to providers to adjust medication dosages for estimated GFR, etc?
- Can we use our electronic health information or paging system to relay clinical information to members of the care team: e.g. alerts by email, text page, fax, or CPOE
- Is there a precedent anywhere in our institution for feeding back individual (or service line) performance to providers?
- Do we have an electronic medical record? CPOE? Digital radiology?
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