Critical Care Explorations (Jun 2023)

Implementation of a Virtual Interprofessional ICU Learning Collaborative: Successes, Challenges, and Initial Reactions From the Structured Team-Based Optimal Patient-Centered Care for Virus COVID-19 Collaborators

  • Simon Zec, MD,
  • Nika Zorko Garbajs, MD,
  • Yue Dong, MD,
  • Ognjen Gajic, MD,
  • Christina Kordik, MA,
  • Lori Harmon, RRT, MBA, CPHQ,
  • Marija Bogojevic, MD,
  • Romil Singh, MD,
  • Yuqiang Sun, MD,
  • Vikas Bansal, MD,
  • Linh Vu, MD,
  • Kelly Cawcutt, MD,
  • John M. Litell, DO,
  • Sarah Redmond, PhD,
  • Eleanor Fitzpatrick, RN,
  • Kirstin J. Kooda, PharmD,
  • Michelle Biehl, MD,
  • Neha S. Dangayach, MD,
  • Viren Kaul, MD,
  • June M. Chae, MD,
  • Aaron Leppin, MD,
  • Mathew Siuba, MD,
  • Rahul Kashyap, MBBS,
  • Allan J. Walkey, MD,
  • Alexander S. Niven, MD,
  • on behalf of the Structured Team-based Optimal Patient-Centered Care for Virus COVID-19 (STOP-VIRUS) Collaborative,
  • Anthony Martinez, MD,
  • Dean Meadows, MD,
  • Helen Stinnett, BA, RRT,
  • Michael Allison, MD,
  • Olubukola Adeyemi, PharmD,
  • Terry Herbert, BSN, RN,
  • Gerald L. Weinhouse, MD,
  • Namrata Patil, MD, MPH,
  • Gaspar Hacobian, PharmD, BCPS,
  • Kamen Rangelov, MD,
  • Jillian Parker, RRT,
  • Michael P. Smith, PharmD, BCCCP,
  • Rachel Smith, RN, MSN, MBA, CCRN,
  • Eliza Deery, MD,
  • Andrea Harper, MS,
  • Emily Davis, RN, CCRN,
  • Grace M. Arteaga, MD, FAAP, FCCM,
  • Jennifer L. Fleegel, RN, CCRN,
  • Julie M. Duncan, RN,
  • Kevin K. Graner, RPh,
  • Tammy J. Schultz, RRT, LRT,
  • Abhishek Giri, MBBS,
  • Ashley Gill, RRT,
  • Catherine L. Mielke, MS, APRN, CNS,
  • Devang Sanghavi, MD, MHA,
  • Jonathan K. Clark, RRT,
  • Julie Shimp, RN,
  • Lisa Marshall, MSN, RN,
  • Michael Spiros, MSN, RN,
  • Nirmaljot Kaur, MD,
  • Sean P. Kiley, MD,
  • Siva Naga Yarrarapu, MBBS,
  • Teresa Keister, RN,
  • Gage Stroope, LRT, CRT,
  • Jackie Stark, PharmD, BCPS,
  • Jessica Poehler, RN,
  • Juan Pablo,
  • Domecq Garces, MD,
  • Nitesh Kumar Jain, MD, MBBS,
  • Syed Anjum Khan, MD,
  • Thoyaja Koritala, MD,
  • Abigail La Nou, MD, FACEP,
  • Christina Hall, MS, RN,
  • Cindy Christensen, MSN, RN, FNP-BC,
  • Kirsten Holbrook, RRT,
  • Sara Toufar, PharmD, RPh,
  • Sarah Normand, PharmD, RPh,
  • Amy Spitzner, RN, CCRN,
  • Carissa Quinn, APRN, CNS, DNP,
  • Christina Xia, PharmD, BCCCP,
  • Holly D. Behrns, LRT, RRT,
  • Erin Barreto, PharmD, RPh,
  • Jennifer Elmer, APRN, CNS, DNP,
  • Sarah Chalmers, MD, PCCM,
  • Macy Cooper, RN,
  • Aaron Harthan, PharmD, BCPPS,
  • Edmundo A. Martinez, MD,
  • Jennifer A. Bandy, RN, BSN,
  • John Sanford, RRT-ACCS, RRT-NPS,
  • Jackie A. Guiliani, BSRT, RRT-NPS,
  • Megan Kupferschmid, MSN, RN, P-CCRN,
  • Anand Pariyadath, MD,
  • Brandy Vitielliss, BSN, RN,
  • Daniel Temas, MD,
  • Smith F. Heavner, MS, RN, PCCN,
  • Amanda Frary, MSN, RN,
  • Murtaza Akhter, MD,
  • Rania Rahman, MD,
  • Mary Mulrow, RN, MN, CCRP,
  • Tracy Cooper, RN,
  • John M. Litell, DO, FACEP,
  • June Mee Chae, MD,
  • Kelly Cawcutt, MD, MS, FACP, FIDSA,
  • Kirstin J. Kooda, PharmD, RPh,
  • Michelle Biehl, MD,
  • Neha S. Dangayach, MD, MSCR,
  • Sarah Redmond, PhD,
  • Viren Kaul, MD,
  • Matthew Siuba, DO,
  • Aaron B. Holley, MD,
  • Alexander A. Kon, MD, MS,
  • Amita Avadhani, PhD, DNP, CNE, DCC, ACNP-BC, NP-C, CCRN, FAANP, FCCM,
  • Amy L. Dzierba, PharmD, FCCP, BCCCP, FCCM,
  • Andre C. Kalil, MD, MPH, FACP,
  • Kelly Cawcutt, MD, MS, FACP, FIDSA,
  • Ashley D. DePriest, MS, RDN, CNSC,
  • Bradley Peters, PharmD, RPh, BCSP, BCCCP,
  • Brenda T. Pun, DNP, RN, FCCM,
  • Courtney E. Bennett, DO,
  • Eric Kriner, BS, RRT,
  • Erin S. DeMartino, MD,
  • Erin Strong, BSN, RN, CCRN,
  • Giora Netzer, MD,
  • Greg S. Martin, MD, MSc, FCCM,
  • Jerry J. Zimmerman, MD, PhD, FCCM,
  • Julia Taylor, MD, MA, HEC-C,
  • Karen A. Korzick, MD, MA, FCCP, FACP, FCCM,
  • Katherine Fischkoff, MD, MPA, FACS,
  • Lewis J. Kaplan, MD, FACS, FCCM,
  • Marlies Ostermann, MD, PhD,
  • Mary Susan Gaeta, MD, FACP,
  • Mary Faith Marshall, HEC-C, PhD,
  • Nahreen Ahmed, MD, MPH,
  • Paul Alan Nyquist, MD, MPH,
  • Pooja A. Nawathe, MD, FAAP, CHSE-A, CHSOS, FCCM,
  • Preeti R. John, MD, MPH, FACS, CPE, HEC-C,
  • Uzma Syed, DO, FIDSA

DOI
https://doi.org/10.1097/CCE.0000000000000922
Journal volume & issue
Vol. 5, no. 6
p. e0922

Abstract

Read online

IMPORTANCE:. Initial Society of Critical Care Medicine Discovery Viral Infection and Respiratory illness Universal Study (VIRUS) Registry analysis suggested that improvements in critical care processes offered the greatest modifiable opportunity to improve critically ill COVID-19 patient outcomes. OBJECTIVES:. The Structured Team-based Optimal Patient-Centered Care for Virus COVID-19 ICU Collaborative was created to identify and speed implementation of best evidence based COVID-19 practices. DESIGN, SETTING, AND PARTICIPANTS:. This 6-month project included volunteer interprofessional teams from VIRUS Registry sites, who received online training on the Checklist for Early Recognition and Treatment of Acute Illness and iNjury approach, a structured and systematic method for delivering evidence based critical care. Collaborators participated in weekly 1-hour videoconference sessions on high impact topics, monthly quality improvement (QI) coaching sessions, and received extensive additional resources for asynchronous learning. MAIN OUTCOMES AND MEASURES:. Outcomes included learner engagement, satisfaction, and number of QI projects initiated by participating teams. RESULTS:. Eleven of 13 initial sites participated in the Collaborative from March 2, 2021, to September 29, 2021. A total of 67 learners participated in the Collaborative, including 23 nurses, 22 physicians, 10 pharmacists, nine respiratory therapists, and three nonclinicians. Site attendance among the 11 sites in the 25 videoconference sessions ranged between 82% and 100%, with three sites providing at least one team member for 100% of sessions. The majority reported that topics matched their scope of practice (69%) and would highly recommend the program to colleagues (77%). A total of nine QI projects were initiated across three clinical domains and focused on improving adherence to established critical care practice bundles, reducing nosocomial complications, and strengthening patient- and family-centered care in the ICU. Major factors impacting successful Collaborative engagement included an engaged interprofessional team; an established culture of engagement; opportunities to benchmark performance and accelerate institutional innovation, networking, and acclaim; and ready access to data that could be leveraged for QI purposes. CONCLUSIONS AND RELEVANCE:. Use of a virtual platform to establish a learning collaborative to accelerate the identification, dissemination, and implementation of critical care best practices for COVID-19 is feasible. Our experience offers important lessons for future collaborative efforts focused on improving ICU processes of care.