Automating Ambulatory Central Line Data Capture and Calculations

Ambulatory central line-associated bloodstream infections (A-CLABSIs) cause significant morbidity, are costly, and are a relatively new patient safety target. To calculate A-CLABSI rates, the total ambulatory line-day denominator must be known; however, few hospitals can measure this accurately. Access to this data is vital to the quality improvement process.

The project aimed to automate the collection of central line (CL) information from the electronic health record (EHR) and the calculation of ambulatory CL days to within a 5% variance rate compared with the manual process to monitor and improve A-CLABSI rates.

Existing documentation processes were analyzed, and appropriate fields were determined for CL data capture. Multiple revisions were needed to hard-wire accurate EHR documentation in identified areas. An algorithm was developed to identify and electronically track CL insertions/removals and calculate days. We completed 9,533 manual chart reviews, correcting retrospective data errors in documentation (EID), and implemented a process to address EID in real time to ensure accurate data and sustainability.

The EHR automated process identified an adjusted average of 98% of patients with a CL compared with the manual process with a variance of 0.3% between June 2024 and May 2025. The inpatient and ambulatory variance rates were 3.50 and 5.2%, respectively. The automated process identified an adjusted average of 96% total CL days compared with the manual process, with an average variance rate of 3.2% . Inpatient and ambulatory CL day calculations had variance rates of 0.7 and 4.5% respectively, compared with the manual process. The average EID rate for all CLs was 12.8%.

Through real-time electronic data capture, a more efficient and sustainable process for maintaining accurate CL data and calculating A-CLABSI rates was developed.