AHRQ to Expand Implementation of CUSP Across All 50 States, District of Columbia, and Puerto Rico

The Agency for Healthcare Research and Quality (AHRQ) has awarded the Health Research & Educational Trust (HRET) nearly $7 million to support projects aimed at preventing healthcare-associated infections (HAIs), such as central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs).

The projects will include a national expansion of the Michigan Health & Hospital Association Keystone Center Project, which within 18 months successfully reduced the rate of central-line blood stream infections in more than 100 Michigan intensive care units and saved 1,500 lives and $200 million. As a result of support from AHRQ and a private foundation, hospitals from all 50 states, the District of Columbia, and Puerto Rico, have the opportunity to participate in a Comprehensive Unit-based Safety Program, known as CUSP, to help prevent infections related to the use of central line catheters. This national initiative should reduce rates of CLABSI and improve organizational safety and culture.

In addition to expanding the geographic reach of the original project, AHRQ is including all hospitals that wish to participate and is funding the expansion to units beyond the ICU within at least 10 hospitals in 10 states.

The project, “On the CUSP: Stop BSI,” is led by HRET in partnership with the Johns Hopkins University Quality & Safety Research Group (QSRG) and the Michigan Health & Hospital Association (MHA) Keystone Center for Patient Safety & Quality. HRET is an affiliate of the American Hospital Association (AHA).

The funds also will be used to reduce the most frequent of HAIs, catheter-associated urinary tract infections (CAUTI). AHRQ will be considering candidate states for this initiative, called “On the CUSP: Stop CAUTI,” within the next two months.

“Hospitals are committed to reducing healthcare acquired infections and this partnership with AHRQ will promote practices that have been shown to lessen their incidence dramatically,” said Rich Umbdenstock, president and CEO of the American Hospital Association.

“Translating evidence into clinical practice is often prevented by attitudes, behaviors, and by the organization of our work units,” said John Combes, MD, senior fellow at HRET and principal investigator of the AHRQ-funded project. “The CUSP model has successfully overcome those barriers by providing a template for unit-based cultural transformation in the way we accomplish our daily work.”

“We are embarking on this national program to reduce CLABSI and improve safety culture. By preventing annually 30,000 to 62,000 CLABSI deaths, this will be the Polio Campaign of the 21st Century,” said Peter J. Pronovost, MD, PhD. “We will do this by using standardized practice including checklists and other tools, improving culture, and employing robust measurement of infections rates. CUSP is a powerful patient safety methodology that can tackle the many other preventable ills that plague our health system.”

“The lessons learned through Michigan hospitals’ voluntary and sustained patient safety efforts are replicable nationwide,” said Spencer Johnson, president of the MHA. “Hospitals across the country participating in these types of programs continue to exemplify extraordinary commitment to improving patient safety and lowering health care costs.”

This new funding is part of a larger effort that AHRQ is supporting to prevent other HAIs, such as methicillin-resistant Staphylococcus aureus, Clostridium difficile, and Klebsiella pneumoniae Carbapenemase. This new funding is the latest effort to further the Department of Health and Human Services’ Action Plan to Prevent Healthcare-Associated Infections, which was released in January and calls for significant reductions in HAIs nationwide within 5 years. It establishes national goals, benchmarks and an integrated information system strategy to monitor HAIs and prioritizes recommended clinical practices for fighting HAIs.