Factors That Affect Spread (Audio/Video item) CUSP Toolkit The CUSP toolkit includes training tools to make care safer by improving the foundation of how your physicians, nurses, and other clinical team members work together.Factors That Affect Spread Factors That Affect Spread [ - 6 min 8 sec] Your browser doesn't support JavaScript. Please upgrade to a modern browser or enable JavaScript in your existing browser. Content on this page requires a newer version of Adobe Flash Player. Current as of February 2013 Internet Citation: Factors That Affect Spread: CUSP Toolkit. February 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/videos/10b_impactspread/index.html