On the CUSP: Stop BSI

What the data tell us…

Face to Face MeetingMassachusetts

November 16, 2010

On the CUSP: Stop BSI

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)

3

Data In – Information Out: CLABSI

Enter 2 data points Access to state and national comparisons

4

Data In – Information Out: MTCT

Answer 18 questions Access activity and barrier reports

5

Data Completeness

6

CLABSI: Mean Rate

Goal: <1 BSI per 1,000 line-days

7

CLABSI: Estimated Impact

BSIsAttributable

deaths Excess CostAdditional

hospital daysQ3-2009 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 7 0.861 $371,000 56State Total 55 6.765 $2,915,000 440

Assumptions: 12.3% case fatality rate $53,000 per BSI; 8 days per BSI

8

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%

9

*Total number of responses: 34/108 (31%)

MTCT: CUSP Activities (Q2&Q3 2010)

1. Science of Safety Training- All/most staff viewed video: 56%- Video in orientation: 18%

2. Staff Identify Defects- Prioritized safety issues: 18%

3. Senior Executive Partnership- Met with senior executive: 0.9/month

4. Learning from Defects- Learned from defects: 24%- Shared results: 18%

5. Teamwork Tools

10 *Total number of responses: 34/108 (31%)

MTCT: CLABSI Practices

11

ALL

MOST

SOME

FEW

Central Line Checklist Compliance

MTCT: Top Barriers (Q2&Q3-2010)

1. Not enough time: 65% (tie)

1. Physician buy-in: 65% (tie)

2. Nursing buy-in: 53% (tie)

2. Physician leadership support: 53% (tie)

3. Autonomy/authority: 41%12

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

13

14

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)

15