Table 4.

Suggested implementation strategies for consensus recommendations from Delphi panel participants

1. Secure buy-in from leaders and key stakeholders (e.g., PICU clinicians, consultants, patient/families) by providing literature supporting recommended practices

2. Assess local practices and engage stakeholders to adapt the recommendations for local guidelines

3. Provide education (e.g., orientation, presentations, reminders) to PICU clinicians

4. Prepare materials (e.g., scripts) to explain recommended practices (e.g., peripheral culture) to patients and families

5. Apply a phased implementation strategy [(e.g., starting with a subset of PICU patients and growing/spreading to other PICU populations (patients “outside” of algorithm)]

6. Use the electronic medical record and other tools/technologies (e.g., text messages) to integrate recommended practices into daily workflow (e.g., order sets/best practice alerts) and address other system challenges (e.g., unit layout and spatial distance between physician workroom and patient rooms)

7. Collect data on compliance with, and impacts of, recommended practices and provide feedback to leaders and key stakeholders continuously