Patient Safety Effort Pioneered by Michigan Hospitals ...

FOR IMMEDIATE RELEASE Contact: Kevin Downey, MHA
Sept. 12, 2012 (517) 703-8623

Patient Safety Effort Pioneered by Michigan Hospitals
Proves Successful Nationally

Central line bloodstream infections reduced 40 percent in 1,100 adult ICUs

Media Statement

The statement is attributable to Spencer Johnson, president of the Michigan Health & Hospital Association, as it
relates to Sept. 10 announcement in the news release contained on the following page:

“Patients around the country are now proven to be safer as a result of collaborative efforts that
began voluntarily in Michigan hospitals nearly 10 years ago. The development of the Comprehensive
Unit-based Safety Program (CUSP) by Johns Hopkins Medicine — and the large scale adoption and
implementation by forward-thinking hospital leaders in the Great Lakes state — has empowered a nation
of clinicians and hospital leaders to make health care safer. The MHA Keystone Center is proud to have
worked collaboratively with the experts at Johns Hopkins University, and the American Hospital
Association’s Health Research & Educational Trust to develop the CUSP toolkit that helped front-line
clinicians so remarkably. Michigan hospitals continue to be incubators for innovative patient safety and
quality research and implementation to ensure patients in Michigan — and everywhere — can benefit
from the power of research, collaboration, and evidence based best-practice.”

About On the CUSP: Stop Bloodstream Infections (BSI)

An estimated 250,000 central line-associated bloodstream infections (CLABSIs) occur nationally each year,
resulting in as many as 62,000 deaths. Through On the CUSP: Stop BSI, hospitals across the country are
collaborating to improve safety culture and reduce the average rate of CLABSIs to less than one per 1,000 central-
line days using the MHA Keystone: Intensive Care Unit (ICU) model. The national project involved hospital teams
at more than 1,100 adult ICUs in 44 states over a 4-year period. Thus far, the preliminary findings indicate that
participating hospitals have reduced the rate of CLABSIs nationally from 1.903 infections per 1,000 central line
days to 1.137 infections per 1,000 central-line days, an overall reduction of 40 percent.

The MHA Keystone Center, the Johns Hopkins University Quality and Safety Research Group and the Health
Research & Educational Trust work together to provide hospitals participating in the project with the necessary tools
and training to reduce these infections in hospital ICUs. Participants, in an effort to improve the patient safety
culture, are implementing a checklist to ensure compliance with safety practices and integrate enhanced
communication, teamwork and leadership.

About the MHA Keystone Center

Based in Lansing, the MHA represents Michigan’s health systems and community hospitals and successfully
advocates on behalf of hospitals and the patients they serve. The MHA addresses key issues in the legislative and
regulatory arenas to advance initiatives that protect quality, cost-effective and accessible care. To learn more, visit
www.mha.org. The MHA Keystone Center is a nonprofit organization that brings patient safety experts and
hospitals together to work in collaborative programs to improve patient safety and health care quality and to reduce
medical errors. To date, the center has been funded by MHA-member hospitals, the AHRQ, Blue Cross Blue Shield
of Michigan, the Centers for Disease Control and Prevention, and the Michigan Department of Community Health.
For more information, visit www.mhakeystonecenter.org.

Press Release

Advancing Excellence in Health Care

EMBARGOED FOR RELEASE Contact: AHRQ Public Affairs
Monday, September 10, 2012, 3:00 p.m., ET (301) 427-1244
AHA Media Relations
(202) 638-5491

AHRQ patient safety project reduces bloodstream infections by 40 percent

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 health
care costs.

The agency and key project partners from the American Hospital Association (AHA) and
Johns Hopkins Medicine discussed these dramatic findings at the AHRQ annual conference
today 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.”

CLABSIs are one type of healthcare-associated infection (HAI). HAIs are infections that
affect patients while they are receiving treatment for another condition in a health care setting.
HAIs are a common complication of hospital care, affecting one in 20 patients in hospitals at any
point in time.

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. Based on
the experiences gained in this successful project, the CUSP toolkit helps doctors, nurses, and

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U.S. Department of Health and Human Services

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other members of the clinical team understand how to identify safety problems and gives them
the tools to tackle these problems that threaten the safety of their patients. It includes teaching
tools and resources to support implementation at the unit level.

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.

“This partnership between the federal government and hospitals provides clear evidence
that we can protect patients from these deadly infections,” said AHA President and CEO Richard
J. Umbdenstock. “Hospitals remain committed to curtailing CLABSIs and enhancing safety in all
clinical settings. Tools such as CUSP go a long way toward accomplishing that goal.”

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.”

In addition, CUSP also builds on important work led by the Centers for Disease Control
and Prevention and its evidence-based recommendations on treating infections. Together with
HHS’ National Action Plan to Prevent Healthcare Associated Infections
(http://www.hhs.gov/ash/initiatives/hai/index.html) and the Partnership for Patients
(http://www.healthcare.gov/compare/partnership-for-patients/), AHRQ’s efforts are a part of a
coordinated approach drawing on the strengths and expertise across HHS.

Details about AHRQ’s national CUSP project are available at
http://www.ahrq.gov/qual/hais.htm. AHRQ’s CUSP toolkit is available at
www.ahrq.gov/cusptoolkit/.

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