2017 Vascular Access Management_ PDSA Worksheet Survey

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* 1. Facility Information

Facility Name

Facility CCN (Medicare Provider Number)

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* 2. What is your facility's TOP 2 areas for quality improvement regarding the vascular access manager or vascular access team? These TOP 2 barriers/root causes should reflect your current vascular access manager and vascular access team.

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* 3. Review your TOP 2 root causes or barriers from question 2, then select 2 interventions that you predict can improve or enhance the quality of the vascular access manager role. You may choose from the list below or write in your 2 interventions you want to run rapid improvement cycles with using the PDSA model.

Vascular Access manager will complete the Vascular Access Manager Competency Training that is required by organization.

Vascular Access Manager will implement skills validation day for the clinical staff this month to ensure policy and procedure is being followed for cannulation & CVC care.

Vascular Access Manager will implement or develop the facility algorithm or pathway for early referral for vessel mapping and surgical appointments.

Facility Administrator/Clinical Manager will implement a vascular access management role or team within the facility.

Vascular Access Manager will implement CVC tracking tool.

Vascular Access Manager will implement a process for appointment reminders for patients.

Vascular Access Manager will implement a process for communication with the clinical staff regarding vascular accesses in the facility.

Vascular Access Manager will implement appointment follow up process to reschedule missed appointments.

Vascular Access Manager will implement a patient engagement activity (ie lobby day regarding the benefits of permanent access)

Vascular Access manager will reach out to the local surgeon's office to establish a process for early patient referral and follow up.

Vascular Access manager will implement a lunch and learn or in-service on vascular access complications with the facility clinical staff.

Vascular Access Manager will create or implement a vascular access assessment tool to provide early referral for access complications.

Vascular Access Manager will audit facility clinical staff this month to ensure policy and procedure adherence.

Vascular Access Manager will attend QAPI meetings and provide update to the Interdisciplinary team.

FA or clinic manager will set up weekly IDT meetings with the Vascular Access Manager to discuss high CVC rates and long term catheter reduction plan.

Additional Vascular Access Manager interventions not listed above that my facility identified as opportunity for improvement:

2017 Vascular Access Management_ PDSA Worksheet

Information on PDSA cycle & copy of this worksheet are in the Catheter Reduction Toolkit pg 7-10

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* 1. Facility Information

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* 2. What is your facility's TOP 2 areas for quality improvement regarding the vascular access manager or vascular access team? These TOP 2 barriers/root causes should reflect your current vascular access manager and vascular access team.

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* 4. Background: Brainstorm potential solutions based on barriers/root cause prioritized by your QI team.

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* 5. Plan: What is the objective of this improvement cycle?

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* 6. Predictions (what do we want to have happen):

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* 7. Plan for change or test: (who, what, when, where)

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* 8. Plan for collection of data: who what when where how will it be collected?

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* 9. PDSA (Do)-Was the cycle carried out as planned? What did we observe that was not a part of our plan?

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* 10. PDSA (Study)-How did or didn't the results of this cycle agree with the predictions that we made earlier?

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* 11. List what new knowledge we gained from this cycle:

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* 12. PDSA (ACT)-List actions we will take as a result of this cycle:

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* 13. PDSA (ACT) Plan for the next cycle?