TY - JOUR
T1 - Maintaining and sustaining the On the CUSP
T2 - Stop BSI model in Hawaii
AU - Lin, Della M.
AU - Weeks, Kristina
AU - Holzmueller, Christine G.
AU - Pronovost, Peter J.
AU - Pham, Julius Cuong
N1 - Funding Information:
This work was funded in part by philanthropic gifts to the Johns Hopkins Quality and Safety Research Group from an anonymous donor and from the Sandler Foundation of the Jewish Community Endowment Fund and by the Hawaii Medical Service Association. This manuscript is derived from work supported under a contract with the Agency for Healthcare Research and Quality (AHRQ) (Contract No. HHSA290200600022, task order #7). However, this manuscript has not been approved by the agency.
PY - 2013/2
Y1 - 2013/2
N2 - Background: Hawaii joined the On the CUSP: Stop BSI national effort in the United States in 2009 (CUSP stands for Comprehensive Unit-based Safety Program). In the initial 18-month study evaluation, adult ICUs decreased central line-associated bloodstream infection (CLABSI) rates by 61%. The impact of a series of novel strategies/tools in reducing infections and sustaining the collaborative in ICUs and non - ICUs in Hawaii was assessed. Methods: This cohort collaborative consisted of 20 adult ICUs and 18 nonadult ICUs in 16 hospitals. Hawaii developed and implemented six tools between July 2010 and August 2011: a tool to investigate CLABSIs, a video to address cultural barriers, a standardized dressing change kit, a map of the cohort's journey, a 12-strategies leadership dashboard, and a geometric plot of consecutive infection-free days. The primary outcome measure was overall CLABSI rates (mean infections per 1,000 catheter-days). Results: A comparison of baseline data from 28 ICUs with 12-quarter (36-month) postimplementation data indicated that the CLABSI rate decreased across the entire state: overall, 1.57 to 0.29 infections/1,000 catheter-days; adult ICUs, 1.49 to 0.25 infections/1,000 catheter-days; nonadult ICUs, 2.54 to 0.33 infections/1,000 catheter-days, non - ICUs (N = 14), 4.52 to 0.25 infections/1,000 catheter-days, and PICU/NICU (N = 4), 2.05 to 0.53 infections/1,000 catheter-days. Days between CLABSIs in the adult ICUs statewide increased from a median of 5 days in 2009 to 70 days in 2011. Discussion: Hawaii successfully spread the program beyond adult ICUs and implemented a series of tools for maintenance and sustainment. Use of the tools shaped a culture around the continued belief that CLABSIs can be eradicated, and infections further reduced. Copyright 2013
AB - Background: Hawaii joined the On the CUSP: Stop BSI national effort in the United States in 2009 (CUSP stands for Comprehensive Unit-based Safety Program). In the initial 18-month study evaluation, adult ICUs decreased central line-associated bloodstream infection (CLABSI) rates by 61%. The impact of a series of novel strategies/tools in reducing infections and sustaining the collaborative in ICUs and non - ICUs in Hawaii was assessed. Methods: This cohort collaborative consisted of 20 adult ICUs and 18 nonadult ICUs in 16 hospitals. Hawaii developed and implemented six tools between July 2010 and August 2011: a tool to investigate CLABSIs, a video to address cultural barriers, a standardized dressing change kit, a map of the cohort's journey, a 12-strategies leadership dashboard, and a geometric plot of consecutive infection-free days. The primary outcome measure was overall CLABSI rates (mean infections per 1,000 catheter-days). Results: A comparison of baseline data from 28 ICUs with 12-quarter (36-month) postimplementation data indicated that the CLABSI rate decreased across the entire state: overall, 1.57 to 0.29 infections/1,000 catheter-days; adult ICUs, 1.49 to 0.25 infections/1,000 catheter-days; nonadult ICUs, 2.54 to 0.33 infections/1,000 catheter-days, non - ICUs (N = 14), 4.52 to 0.25 infections/1,000 catheter-days, and PICU/NICU (N = 4), 2.05 to 0.53 infections/1,000 catheter-days. Days between CLABSIs in the adult ICUs statewide increased from a median of 5 days in 2009 to 70 days in 2011. Discussion: Hawaii successfully spread the program beyond adult ICUs and implemented a series of tools for maintenance and sustainment. Use of the tools shaped a culture around the continued belief that CLABSIs can be eradicated, and infections further reduced. Copyright 2013
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U2 - 10.1016/s1553-7250(13)39008-4
DO - 10.1016/s1553-7250(13)39008-4
M3 - Article
C2 - 23427476
AN - SCOPUS:84874523346
SN - 1553-7250
VL - 39
SP - 51
EP - 60
JO - Joint Commission Journal on Quality and Patient Safety
JF - Joint Commission Journal on Quality and Patient Safety
IS - 2
ER -