The CLABSI Playbook: Design and Implementation of a Multipronged Approach to Decrease CLABSIs

Area of Science:

• Healthcare quality improvement
• Infection control
• Patient safety in critical care

Background:

• Central line-associated blood stream infections (CLABSIs) are a critical care quality indicator with substantial patient safety and economic implications.
• The healthcare system identified CLABSI rates exceeding the national average, necessitating targeted interventions.
• CLABSIs incur significant costs, estimated at nearly a billion dollars annually, and negatively impact patient outcomes.

Purpose of the Study:

• To investigate and reduce elevated central line-associated blood stream infection (CLABSI) rates within the hospital system.
• To implement and evaluate a comprehensive quality improvement framework to mitigate healthcare-associated infections.
• To achieve CLABSI rates at or below the national average, thereby improving patient safety.

Main Methods:

• Conducted a thorough analysis of system-specific CLABSI rates compared to national benchmarks.
• Established dedicated committees and identified key stakeholders to drive the quality improvement initiative.
• Employed root cause analysis, procedural adjustments, continuous monitoring, and system-wide scaling of interventions.

Main Results:

• Achieved a reduction in CLABSI rates by over 40% from 2021 to the fourth quarter of 2022.
• Sustained CLABSI rates below or around the national average (0.86 per 1,000 line days) for the final three quarters of 2022.
• Demonstrated the effectiveness of the implemented quality improvement structure in reducing infection rates.

Conclusions:

• The structured quality improvement approach proved effective in significantly decreasing CLABSI rates.
• The initiative successfully brought the hospital system's CLABSI rates in line with national averages.
• Continuous monitoring and adaptation of procedures are crucial for sustained reduction of healthcare-associated harm.