News: AHRQ Patient Safety Project Reduces Bloodstream Infections by 40 Percent

September / October 2012


AHRQ Patient Safety Project Reduces Bloodstream Infections by 40 Percent

Over a 4-year period, 1,100 ICUs in 44 states used the Comprehensive Unit-based Safety Program (CUSP) to prevent infections.

A unique nationwide patient safety project funded by the Agency for Healthcare Research and Quality (AHRQ) reduced the rate of central line-associated bloodstream infections (CLABSIs) in intensive care units by 40 percent, according to the agency’s preliminary findings of the largest national effort to combat CLABSIs to date. The project used the Comprehensive Unit-based Safety Program (CUSP) to achieve its landmark results that include preventing more than 2,000 CLABSIs, saving more than 500 lives, and avoiding more than $34 million in healthcare costs.

The agency and key project partners from the American Hospital Association (AHA) and Johns Hopkins Medicine discussed these dramatic findings September 10, 2012, at the AHRQ annual conference in Bethesda, Md., and introduced the CUSP toolkit that helped hospitals accomplish this marked reduction.

“CUSP shows us that with the right tools and resources, safety problems like these deadly infections can be prevented,” said AHRQ Director Carolyn M. Clancy, M.D. “This project gives us a framework for taking research to scale in practical ways that help front-line clinicians provide the safest care possible for their patients.”

The national project involved hospital teams at more than 1,100 adult intensive care units (ICUs) in 44 states over a 4-year period. Preliminary findings indicate that hospitals participating in this 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, an overall reduction of 40 percent.

The CUSP is a customizable program that helps hospital units address the foundation of how clinical teams care for patients. It combines clinical best practices with an understanding of the science of safety, improved safety culture, and an increased focus on teamwork.

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.

CUSP was created by a team led by Peter J. Pronovost, M.D., Ph.D., senior vice president for patient safety and quality at Johns Hopkins Medicine. “It is gratifying that this method has become such a powerful engine for improving the quality and safety of care nationwide,” said Dr. Pronovost. “It is a really simple concept; trust the wisdom of your front-line clinicians.”

Details about AHRQ’s national CUSP project are available at AHRQ’s CUSP toolkit is available at