ACTION II Project Awards, Fiscal Year 2011

ACTION II is a model of field-based research designed to promote innovation in health care delivery by accelerating the diffusion of research into practice. The ACTION II network includes 17 large partnerships and more than 350 collaborating organizations that provide health care to an estimated 50 percent of the U.S. population.

Select for the ACTION II Fact Sheet.

Select for Awards in Fiscal Years 2009 and 2010.

Patient Safety

Title: Development of an Integrated Toolkit/Resource Guide for Falls Prevention in Hospitals
Description: This project will result in a Web-based resource guide/toolkit on falls prevention that: (1) can guide an interdisciplinary team in a hospital in implementing a comprehensive intervention with support from other organizational components of the hospital; (2) is useful to hospitals with varying level of falls prevention sophistication; (3) can be readily adapted to local circumstances; (4) follows a similar design to that of the AHRQ guide for pressure ulcer prevention in hospitals; (5) recommends tools that can be used with the guide and provides evidence of the relative validity of the tools; and (6) references additional resources for organizations that want to delve deeper into specific aspects of program implementation.
Partner: RAND
ACTION Contact: David Ganz (dganz@mednet.ucla.edu)
Period: July 2011-December 2012
Funding: $595,231
Deliverables: Web-based resource guide.

Title: The AHRQ Harm Scale: Validation With Adverse Events
Description: This project will: (1) develop and produce cognitive testing instruments to investigate how well users understand the seven points of the AHRQ Harm Scale and the revised AHRQ Harm Scale; (2) evaluate the interrater reliability of the revised Harm Scale among clinician chart abstractors with varying levels of clinical training and experience; and (3) develop guidelines for use of the revised Harm Scale for reporting adverse events.
Partner: Kaiser Permanente
ACTION Contact: Julie Schmittdiel (julie.a.schmittdiel@kp.org)
Period: September 2011-September 2013
Funding: $527,559
Deliverables: Guidelines.

Title: Development and Demonstrations of a Surgical Unit-based Safety Program (SUSP) To Reduce Surgical Site Infections (SSIs) and Other Surgical Complications
Description:The project will:

• Create a "CUSP for Safe Surgery" by modifying the CUSP (Comprehensive Unit-based Safety Program) protocol and materials; like CUSP, the SUSP will integrate clinical and cultural interventions (e.g., surgical safety checklist and teamwork assessment).
• Recruit States and hospitals within States to demonstrate the utility of applying SUSP to SSIs and other surgical complications in a phased manner beginning with 10 States and 10 hospitals in each participating State, then in subsequent option years expand to Sll states, Puerto Rico, and the District of Columbia.
• Expand or enhance existing statewide consortia efforts to reduce healthcare-associated infections (HAIs) to include SSIs and surgical complications.

Partner: Johns Hopkins University
ACTION Contact: Peter Pronovost (ppronovo@jhmi.edu)
Period: September 2011-August 2012
Funding: $9,983,790 (Base+3 Option Years)
Deliverables: Module (CUSP for Safe Surgery); phased national implementation of module.

Title: Continued National Implementation of TeamSTEPPS®
Description: This project will continue to implement a program that supports adoption and use of TeamSTEPPS® by health systems, health care provider institutions, and health profession educational institutions nationwide. Specifically, the project will:

• Provide TeamSTEPPS master training to health care personnel interested in using TeamSTEPPS to improve quality and teamwork within their organizations.
• Support the cadre of existing and new master trainers through additional ongoing education via webinars, user group meetings, and the National Collaborative (TeamSTEPPS National Conference).
• Introduce new advanced training to existing and new master trainers by disseminating and providing training on new TeamSTEPPS modules, such as TeamSTEPPS for Rapid Response Systems, Primary Care Medical Office, Long-Term Care, Simulation, and Cross-Cultural Teamwork (Limited English Proficiency).
• Track the progress of TeamSTEPPS users and their sustainability activities.
• Evaluate the impact of the National Implementation program.

Partner: HRET
ACTION Contact: Steve Hines (shines3@aha.org)
Period: September 2011-September 2014
Funding: $3,383,782 (Base+3 Option Years)
Deliverables: National implementation; final report.

Title: Identifying and Aligning Work-System Factors To Reduce Healthcare-Associated Infections (HAIs)
Description: The contractor will:

• Perform a comprehensive review of the literature addressing the role and impact of major work-system factors on HAIs.
• Select an intervention to address an HAI problem; identify the work-system, environmental, and contextual factors that will need to be aligned to successfully implement it; and describe how the process of alignment needs to occur in the practice setting and how one can measure its occurrence.
• Pilot test the intervention, appropriately aligned with work system factors; revise intervention as needed.
• Implement and evaluate the intervention.
• Create a toolkit for use by providers who want to implement the intervention.

Partners: CNA.
ACTION Contacts: Vicki R. Lewis (Vicki.R.Lewis@medstar.net)
Period: September 30, 2011–September 29, 2012
Funding: $1,150,795 (Base+2 Option Years)
Deliverables: Toolkit; final report.

Title: Understanding the Role of Healthcare Facility Design in the Acquisition and Prevention of Healthcare-Associated Infections (HAIs)
Description: This project aims to better understand and describe the role of health care facility design in the acquisition and prevention of HAIs. Specifically, the project will:

• Develop a conceptual framework that describes the relationship between the built environment of health care facilities and the acquisition and prevention of HAIs and that can be used to guide and assess future research to optimize the built environment to reduce HAIs.
• Using the conceptual framework, conduct an environmental scan (literature review and experts) to understand the current state of knowledge of HAI prevention through the use of the built environment.
• Produce a final report that describes the current state of knowledge and future directions for investigations regarding the built environment and the link to HAIs.

Partner: RTI International
ACTION Contact: Doug Kamerow (dkamerow@rti.org)
Period: September 2011-March 2013
Funding: $479,952
Deliverables: Environmental scan report; conceptual framework; manuscripts.

Title: A Prototype of Consumer Reporting System for Patient Safety Events
Description: The contractor will:

• Design and develop a consumer reporting system for patient safety events.
• Conduct usability testing of the prototype consumer reporting system in a variety of settings and using a variety of methods for patient reporting.
• Develop plans for any needed modifications.
• Develop recommendation plan for expanded implementation and evaluation of such a system or systems.
• Execute implementation and evaluation plans.

Partner: RAND
ACTION Contact: Eric Schneider (eschneid@rand.org)
Period: September, 2011-April, 2013
Funding: $2,416,682 (Base+2 Option Years)
Deliverables: Prototype consumer reporting system; testing; implementation and evaluation.

Title: National Implementation of a Comprehensive Unit-based Safety Program (CUSP) To Reduce Catheter-Associated Urinary Tract Infection (CAUTI)
Description: This project will implement CUSP to reduce CAUTI in hospitals in all States, the District of Columbia, and Puerto Rico through State-based or regional consortia/collaboratives in a phased approach. This project will build on activities, resources, and materials of an initial 12-State implementation effort. Specific tasks include recruiting increasing numbers of hospitals in all remaining States in a phased fashion and expanding or enhancing existing statewide consortia efforts to reduce HAIs to include CAUTI.
Partners: HRET
ACTION Contacts: Deborah Bohr (dbohr@aha.org)
Period: September 2011-September 2014
Funding: $19,003,529 (Base+3 Option Years)
Deliverables: Phased national implementation of safety program; final report.

Title: Comprehensive Unit-based Safety Program (CUSP) for Ventilator-Associated Pneumonia (VAP) Prevention
Description: The overall purpose of this project is to accelerate the adoption of care bundles to reduce VAP and to assess the impact of the defined strategies or comprehensive program on VAP rates using a regional or statewide approach. Under this task order, the contractor will:

• Develop and demonstrate in two States the implementation of a comprehensive program to prevent VAP.
• Adapt and apply CUSP to VAP prevention, including selection and use of an intervention bundle to prevent VAP based on the most current evidence.

Partner: Johns Hopkins University
ACTION Contact: Sean Berenholtz (sberenh1@jhmi.edu)
Period: September 2011-March 2013
Funding: $706,902
Deliverables: Toolkit or care bundle for VAP prevention.

Value

Title: System Redesign for Value in Safety Net (SN) Hospitals and Delivery Systems
Description: The purpose of the task order is to identify external supports for system redesign that are available or might be developed by government agencies and other organizations. Tasks include:

• Conducting an environmental scan to learn what is known about system redesign and other routes to achieving value (quality and efficiency) among SNs.
• Using multiple methods to examine how at least six SN hospitals (or hospital systems) use system redesign in pursuit of strategic objectives, which redesigns have been most valuable in promoting these objectives, and what conditions and factors facilitate successful redesign.
• Providing actionable recommendations for SN leaders, plus recommendations for the development of one or more sustainable mechanisms (e.g., training programs, collaboratives) for guiding and supporting SN leaders seeking to attain major improvements in value.

Partner: Boston University
ACTION Contact: Carol Van Deusen Lukas (cvlukas@bu.edu)
Period: September 2011-November 2013
Funding: $499,877
Deliverables: Final report; manuscript.

Title: Reducing Hospital Readmissions for Medicaid Patients
Description: The purpose of this task order is to develop tools and strategies for reducing hospital readmissions for Medicaid patients. Tasks include:

• Identifying factors at the patient, provider, and community level that contribute to hospital readmissions for Medicaid patients through chart review and interviews.
• Developing strategies (or modifying existing ones) to specifically address the unique challenges of Medicaid patients.
• Implementing, testing and revising strategies at selected safety net hospitals in multiple States, in partnership with State Medicaid programs.

Note: Two Task Orders were awarded:

Partner: John Snow, Inc.
Title: Reducing Hospital Readmissions for Medicaid Patients Through a Patient-Centered and Community-Based Approach
ACTION Contact: James Maxwell (maxwell@jsi.com)
Period: September 2011-March 2013
Funding: $567,167 (Base+1 Option Year)
Deliverables: Toolkit/package of specific strategies/tools.

Partner: George Washington University
Title: Reducing Hospital Readmissions for Medicaid Patients Through Collaborative Learning
ACTION Contact: Marsha Regenstein (marshar@gwu.edu)
Period: September 2011-March 2013
Funding: $457,804 (Base+1 Option Year)
Deliverables: Toolkit/package of specific strategies/tools.