TABLE 1.

Time Line of the Endotracheal Culture QI Initiative

	Event
Winter 2016	Initial concern for overuse of EACs
Fall 2017	Review of 1 year of baseline EAC use
November 2017 to January 2018	Surveys of PICU staff after EACs obtained
January to March 2018	Focus groups with PICU staff and development of clinical decision support algorithm
March 26, 2018	Decision support algorithm approved by unit director
March 26–28, 2018	E-mail announcement and algorithm sent to all PICU staff; paper copies placed in work rooms; algorithm posted to intranet Web site accessible to staff
April 1, 2018	Initiation date to start using algorithm
April to May 2018	Paper checklist of algorithm signed by attending physicians and fellows when EACs obtained; Meetings with clinicians to discuss initiative and any safety concerns or observations; QI team walk rounds through the PICU soliciting feedback
May 2018 to June 2019	Quarterly discussion at PICU safety meetings
February 2020	Electronic monitoring dashboard became available