Study procedures — usual supervisor-led audit and feedback at all sites
Usual supervisor-led audit and feedback for nurses and respiratory therapists at Intermountain includes formal and informal conversations at least quarterly between a direct supervisor and an employee to review job performance and to encourage improvement as needed, including adherence to clinical practice standards. Information on job performance is typically captured via direct observation, conversations with the employee’s peers, and performance reports. The number, content, quality, and timing of supervisor-led audit and feedback vary by supervisor. For this study, supervisors at all sites will also receive adherence reporting weekly from a systemwide electronic dashboard on the Intermountain intranet accessible to designated providers. Reports will include adherence data at the system, ICU, clinician, and component (SAT, SBT, coordination) levels and also at the individual patient encounter and patient day levels. Supervisors will be encouraged to use report data to support C-SAT/SBT uptake and to facilitate employee audit and feedback.To further standardize the use of supervisor-led audit and feedback and promote the use of adherence reporting to encourage C-SAT/SBT adherence, education and training activities will occur at all study sites (see Table Strategies to promote supervisor-led audit and feedback at all sites