Development of a Quarterly Scorecard for the Adult Respiratory ECMO Program at VUMC

Abstract

PURPOSE: This project aimed to enhance the quality of Extracorporeal Membrane Oxygenation (ECMO) care at Vanderbilt University Medical Center (VUMC) by developing a quarterly quality and performance scorecard for the adult respiratory ECMO program. Despite VUMC's comprehensive internal quality database, utilization of quality metrics was minimal. Following the Extracorporeal Life Support Organization's (ELSO) guidelines, this initiative sought to improve our program evaluation. METHODS: Development of the ECMO scorecard involved collaborative drafting with key stakeholders during the Fall of 2023. Utilizing data from VUMC's quality assurance database, the scorecard was refined and disseminated to the medical intensive care unit (MICU) advanced practice provider (APP) team in January 2024. Implementation outcomes were measured using the Acceptability of Intervention Measure (AIM) and Intervention Appropriateness Measure (IAM), with higher scores indicating greater acceptability and appropriateness. RESULTS: The scorecard was finalized and distributed to 16 MICU APPs, achieving a 62.5% survey response rate. The feedback indicated high acceptability (AIM mean score: 4.38) and appropriateness (IAM mean score: 4.5) of the ECMO scorecard among respondents. IMPLICATIONS FOR PRACTICE: The successful development of the ECMO scorecard demonstrates its potential to improve clinical practice by providing a valuable tool for quality assessment and improvement. The positive reception among providers supports the utility of similar data analytics tools in enhancing patient care. Future directions include expanding the scorecard with benchmarking data and integrating dynamic access features through REDCap.