VSAP: Phase 1 Intervention

The VSAP initiative encompasses basic fluid monitoring tools (daily weights, total fluid orders, strict intake/output) and more advanced metrics (electronic health record–generated renal angina index score,¹¹ urinary AKI biomarkers, etc.) to assess for FO and its complications. In the first phase (June 2017), a task force identified barriers to the reliable collection of patient weights and then developed and implemented key drivers to increase the frequency and accuracy of patient weight collection. This bundle of interventions is elaborated upon in Figure ​Figure11.

The authors then assessed for changes in weight collection by tracking the following metrics for all patients admitted to the PICU from April to December 2017: (1) percentage of patients who receive a daily weight order upon admission and (2) percentage of patient-days with a weight measurement—with and without a daily weight order.