Chicago Hospital Reduces Catheter-Related Infections to Zero with AHRQ’s CUSP Tools

Saint Anthony Hospital, a 151-bed community hospital in Chicago, reduced catheter-related infections among its patients by 90 percent from 2014 to 2016—and to zero in 2017—by adopting tools and strategies from AHRQ’s Comprehensive Unit-Based Safety Program (CUSP).

The number of patients with a catheter-related bloodstream or urinary tract infection fell from 17 cases in 2014, when the hospital started using CUSP, to just 2 by 2016. The reduced infection rate saved nearly $500,000 in estimated medical costs over the 2-year period, according to hospital officials.

Alfredo J. Mena Lora, M.D., Saint Anthony’s medical director of infection control, attributes the reduced infection rate to using a CUSP strategy known as the communications briefing, or “huddle,” where hospital staff conduct a daily medical care review of each patient, including those using a catheter.

Saint Anthony modified the scope of the traditional huddle in 2014 by introducing infection control components. This created enhanced awareness of whether there was a continued need for patients to use central venous catheters or indwelling urinary catheters, Dr. Mena Lora explained.

“We call it the daily interdisciplinary safety huddle or ‘DISH,’ and it’s been so successful that we’ve expanded it as a hospital-wide practice,” he said. Saint Anthony included the managers of all hospital units and other employees ranging from security to dietary staff to emergency services, as well as infection control practitioners, in the initiative to obtain a variety of perspectives. “DISH provides a forum among hospital personnel that promotes catheter removal, accountability, and a stronger culture of safety,” Dr. Mena Lora said.

Daily assessments are conducted to determine a patient’s need for continued catheter use. When there are barriers for catheter removal, such as a provider’s preference, Saint Anthony leaders get involved to address the situation.

“From an infection control standpoint, we already know that by reducing the unnecessary use of catheters, we also reduce the rate of infection,” Dr. Mena Lora said. “Fewer infections mean that fewer antibiotics are prescribed, which lessens the chance that antibiotic resistance can develop.”

AHRQ’s CUSP methodologies also were beneficial in building senior executive support, improving teamwork and communication, and promoting the science of safety at Saint Anthony, according to Dr. Mena Lora. The hospital adapted some other CUSP resources on catheter use, such as checklists for placement and daily audit/maintenance, so they could be used in the hospital’s electronic health records.

Due to its success in reducing catheter-related infections, Saint Anthony won an Illinois Health and Hospital Association (IHA) Innovation Challenge: Partners in Progress Award in February 2018. IHA’s expert panel of nationally recognized health care quality judges noted Saint Anthony’s significant improvement and impact on reducing patient harm. The award provides grant funding enabling Saint Anthony to implement DISH at additional IHA member hospitals.