Conclusion

On the CUSP: Stop BSI was an unprecedented national improvement collaborative that demonstrated that a national program could be replicated in multiple States and regions from one successful State implementation. Success factors at the national program level included having well-defined, evidence-based interventions; a solid implementation structure and project plan; the collection and use of timely, accurate and actionable data to improve performance; tailoring the national program for local and unit audiences; and the wisdom and flexibility to evolve project strategies and emphases over time. Strong hospital association engagement energized hospital leadership and unit teams.

Hospital units that significantly reduced CLABSI rates had strong leadership engagement from senior management and from physician and nurse champions, understood and embraced the adaptive and technical goals and techniques of the program, monitored their results monthly, and celebrated success. Similarly, State leads in States with the highest unit engagement and often significant CLABSI reduction had the support of their association leadership, took the time to understand the administrative and programmatic aspects of the program to effectively coach their teams, closely monitored each team's results, intervened early with those teams that were struggling, and celebrated successes on coaching calls and at in-person meetings. 

The NPT believes that On the CUSP: Stop BSI  has created a strong foundation for future State and regional quality improvement collaboratives by equipping people to function independently as leaders of future infection prevention and other unit-based QI efforts, demonstrating what is needed in terms of an adequate infrastructure at the State and regional level to support these activities, and by providing the knowledge and materials needed to support ongoing efforts to train hospital staff in unit-based approaches to improving safety and quality for all patients.

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