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Patient safety project reduces infections by 40 percent, saves $34M

During the Agency for Healthcare Research and Quality's (AHRQ) annual conference in Bethesda, Md. on Monday, the agency announced its preliminary findings of its nationwide patient safety project to reduce the rate of central line-associated bloodstream infections (CLABSIs).

The preliminary results of the AHRQ-funded project show decreased CLABSIs in more than 1,100 adult intensive care units nationwide by 40 percent. The agency and its project partners, the American Hospital Association (AHA) and Johns Hopkins Medicine, used the Comprehensive Unit-based Safety Program (CUSP) and were able to prevent more than 2,000 CLABSIs, save more than 500 lives ands avoid more than $34 million in healthcare costs, according to AHRQ Director Carolyn M. Clancy, who spoke during the conference.

[See also: HAIs add millions to health system costs, harm patients]

“This program helps clinical teams provide the best in safety care using a collection of best practices,” said Clancy. “Some hospitals were able to reduce their infections to zero.”

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According to Clancy, the project involved hospital teams in 44 states over the last four years. The findings indicate that hospitals participating in the project reduced the rate of CLABSIs nationally from 1.903 infections per 1,000 central line days to 1.137 infections per 1,000 line days.

CUSP, a customizable program that helps hospital units address the foundation of how clinical teams care for patients, was created by a team led by Peter J. Pronovost, senior vice president for patient safety and quality at Johns Hopkins Medicine. The program combines clinical best practices with an understanding of the science of safety, improved safety culture and an increased focus on teamwork.

According to Pronovost, the CUSP toolkit helps doctors, nurses and other members of the clinical team understand how to identify safety problems and gives them the tools to tackle problems that threaten the safety of their patients. It includes teaching tools and resources to support implementation at the unit level.

[See also: AHRQ releases state quality of care data with mixed findings]

The first broad-scale application of CUSP was in Michigan, under the leadership of the Michigan Health & Hospital Association, where it was used to significantly reduce CLABSIs in that state. Following that success, CUSP was expanded to 10 states and then nationally through an AHRQ contract to the Health Research & Educational Trust, the research arm of the AHA.

Theresa Hickman, a nurse educator at Peterson Regional Medical Center in Kerrville, Texas, spoke at the conference about how she applied the program to her hospital.

“ We are a 125-bed, rural, nonprofit hospital, and during the last 31 months we have not had a single CLABSI in our facility,” said Hickman. “In my 32 years in my nursing program, this is the most powerful program I’ve ever seen.”

Pronovost added that in addition to the released preliminary data, a CUSP toolkit will be released.

“The toolkit helps doctors, nurses and clinicians identify problems and address problems,” he said. “It’s customizable and contains self-paced checklists.”

Details about AHRQ's national CUSP project are available at http://www.ahrq.gov/qual/hais.htm. AHRQ's CUSP toolkit is available at www.ahrq.gov/cusptoolkit/.

 

[See also: HAI report highlights improvement at Pennsylvania hospitals]