1. On the CUSP: Stop BSI

2. On the CUSP: Stop BSI What the data tell us… Face to Face Meeting
Massachusetts
November 16, 2010

3. Learning Objective
To understand state-level progress towards reducing the rate of central line associated blood stream infections (CLABSI) and implementing the Comprehensive Unit-based Safety Program (CUSP)

4. Data In – Information Out: CLABSI
Access to state and national comparisons
Enter 2 data points

5. Data In – Information Out: MTCT
Answer 18 questions
Access activity and barrier reports 5

6. Data Completeness

7. CLABSI: Mean Rate
Goal:
<1 BSI per 1,000 line-days

8. CLABSI: Estimated Impact
BSIs
Attributable deaths
Excess Cost
Additional hospital days
Q3-2009 21
2.583
$1,113,000
168
Q4-2009 17
2.091
$901,000
136
Q1-2010 7
0.861
$371,000 56
Q2-2010 3
0.369
$159,000 24
Q3-2010
State Total 55
6.765
$2,915,000
440
Assumptions: 12.3% case fatality rate
$53,000 per BSI; 8 days per BSI

9. MTCT: General Activities (Q2&Q3 2010)
Teams met average of 1.2 times per month
Reviewed data: 1.4
Shared data with unit: 1.6
Data presented to
Senior leadership: 79%
Board: 65%
53 responses
*Total number of responses: 34/108 (31%)

10. MTCT: CUSP Activities (Q2&Q3 2010)
Science of Safety Training
- All/most staff viewed video: 56%
- Video in orientation: 18%
Staff Identify Defects
- Prioritized safety issues: 18%
Senior Executive Partnership
- Met with senior executive: 0.9/month
Learning from Defects
- Learned from defects: 24%
- Shared results: 18%
Teamwork Tools 10
*Total number of responses: 34/108 (31%)

11. MTCT: CLABSI Practices
Central Line Checklist Compliance
ALL
MOST
SOME
FEW

12. MTCT: Top Barriers (Q2&Q3-2010)
Not enough time: 65% (tie)
1. Physician buy-in: 65% (tie)
Nursing buy-in: 53% (tie)
2. Physician leadership support: 53% (tie)
3. Autonomy/authority: 41%

13. Take Home Points BSI data completeness – Very Good!
MTCT data completeness – Needs Improvement!
Mean BSI rates – Improved since beginning of project, but need to maintain focus
Activities and barriers – Many opportunities to learn from together

15. Learning Objective
To understand state-level progress towards reducing the rate of central line associated blood stream infections (CLABSI) and implementing the Comprehensive Unit-based Safety Program (CUSP)