# Implementing MAGIC to Improve PICC Appropriateness and Patient Outcomes

> **NIH AHRQ R18** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2021 · $399,789

## Abstract

Use of peripherally inserted central catheters (PICCs) for intravenous antibiotics, infusion of
chemotherapy or invasive hemodynamic monitoring has grown substantially in hospitalized
patients. Although such use reflects advantages of PICCs (such as safer insertion in veins of
the arm compared to veins of the neck or chest for conventional central venous catheters), not
all PICCs are placed for appropriate reasons. Furthermore, PICCs are associated with important
complications, including venous thromboembolism (VTE) and central line-associated
bloodstream infection (CLABSI). Identifying and balancing the risks and benefits related to
PICCs is critical to ensuring patient safety.
The long-term objective of this study is to improve use and outcomes of PICCs across hospitals
in the United States. Supported by funding from an AHRQ K award, the PI for this proposal
developed the “Michigan Appropriateness Guide to Intravenous Catheters (MAGIC),” an
evidence-based tool to inform and improve PICC use in hospital settings. This research project
now aims to (a) implement MAGIC across 48-hospitals to determine whether it can improve
appropriateness of PICCs; (b) evaluate whether improvements in PICC appropriateness are
associated with fewer complications; and (c), identify what aspects of implementation at the
hospital level led to the greatest change in appropriateness and complications. The study will
leverage a large Blue Cross/Blue Shield of Michigan-funded collaborative quality improvement
consortium: the Michigan Hospital Medicine Safety (HMS) consortium. Given a robust
infrastructure for data collection and 48-member hospitals all actively engaged in improving
PICC safety, HMS is the ideal setting to test MAGIC. Knowledge generated from this study will
be seminal to making healthcare safer and understanding what provider and systems factors
are associated with hospital performance – both priority areas for AHRQ.
This project will be the first large scale implementation of a tool that has the potential to
substantially improve the safety of thousands of patients that receive PICCs. Exceptional
resources and team with extensive expertise in implementation science, patient safety and
health services research make the University of Michigan an ideal environment for this proposal.

## Key facts

- **NIH application ID:** 10172946
- **Project number:** 5R18HS025891-04
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Vineet Chopra
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $399,789
- **Award type:** 5
- **Project period:** 2018-08-01 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10172946

## Citation

> US National Institutes of Health, RePORTER application 10172946, Implementing MAGIC to Improve PICC Appropriateness and Patient Outcomes (5R18HS025891-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10172946. Licensed CC0.

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