Facilitators and Barriers to Implementing Two Quality Improvement Interventions Across 10 Pediatric Intensive Care...

Area of Science:

• Medical Education
• Healthcare Quality Improvement
• Pediatric Critical Care

Background:

• Quality improvement (QI) initiatives are crucial for enhancing patient outcomes in pediatric intensive care units (PICUs).
• Understanding implementation facilitators and barriers is key to successful adoption of evidence-based interventions.
• Video laryngoscopy (VL)-assisted coaching and apneic oxygenation (AO) are two such interventions with potential benefits.

Purpose of the Study:

• To identify facilitators and barriers to the implementation of VL-assisted coaching and AO in PICUs.
• To compare implementation fidelity between VL-assisted coaching and AO interventions.
• To provide insights for optimizing the dissemination of these QI efforts.

Main Methods:

• Qualitative study involving focus groups with frontline clinicians across 10 PICUs.
• Analysis of common and unique themes related to intervention implementation.
• Monitoring of intervention fidelity based on predefined success criteria for device usage.

Main Results:

• Eighty percent of sites met success criteria for VL-assisted coaching, while 20% met criteria for AO.
• Common facilitators included adequate device accessibility, QI culture, and strong leadership.
• Common barriers were poor device accessibility and perceived delay in care; successful sites cited strong leadership, while unsuccessful sites noted insufficient education.

Conclusions:

• Strong QI leadership and adequate device accessibility are critical facilitators for successful intervention implementation.
• Insufficient education and perceived delays in care act as significant barriers.
• Proactive strategies addressing these facilitators and barriers are essential for effective dissemination of VL and AO interventions in PICUs.