Doing Well by Doing Good: Assessing the Cost Savings of an Intervention to Reduce Central Line–Associated Bloodstream Infections in a Hawaii Hospital

American Journal of Medical Quality

Volumn 29, Issue 1, 2014, Pages 13-19

  Hsu, Eugene ^a   Lin, Della ^b   Evans, Samuel J ^c   Hamid, Kamran S ^d   Frick, Kevin D ^e   Yang, Ting ^a   Pronovost, Peter J ^a   Pham, Julius Cuong ^a  

^a JOHNS HOPKINS UNIVERSITY   (United States)

^b Hawaii On The CUSP   (United States)

^c UNIVERSITY OF HAWAII   (United States)

^d WAKE FOREST SCHOOL OF MEDICINE   (United States)

^e JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

cost savings; critical care; health care economics and organizations; health care quality access and evaluation; insurance health reimbursement; patient safety

Indexed keywords

ADVERSE EFFECTS; CASE CONTROL STUDY; CATHETER-RELATED INFECTIONS; CENTRAL VENOUS CATHETERIZATION; CLINICAL TRIAL; COST CONTROL; CROSS INFECTION; ECONOMICS; EPIDEMIOLOGY; FEMALE; HEALTH CARE COST; HUMAN; MALE; MIDDLE AGED; PROCEDURES; STATISTICS AND NUMERICAL DATA; TERTIARY CARE CENTER; UNITED STATES;

CASE-CONTROL STUDIES; CATHETER-RELATED INFECTIONS; CATHETERIZATION, CENTRAL VENOUS; COST SAVINGS; CROSS INFECTION; FEMALE; HAWAII; HEALTH CARE COSTS; HUMANS; MALE; MIDDLE AGED; TERTIARY CARE CENTERS;

EID: 84928694520     PISSN: 10628606     EISSN: 1555824X     Source Type: Journal    
DOI: 10.1177/1062860613486173     Document Type: Article

References (26)

1. The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
2. Burke JP. Infection control-a problem for patient safety. N Engl J Med. 2003; 348: 651-656.
3. Nowak JE Brilli RJ Lake MR, et al. Reducing catheter-associated bloodstream infections in the pediatric intensive care unit: business case for quality improvement. Pediatr Crit Care Med. 2010; 11: 579-587.
4. Pittet D Tarara D Wenzel RP. Nosocomial bloodstream infections in critically ill patients: excess length of stay, extra costs, and attributable mortality. JAMA. 1994; 271: 1598-1601.
5. Rello J Ochagavia A Sabanes E, et al. Evaluation of outcome of intravenous catheter related infections in critically ill patients. Am J Respir Crit Care Med. 2000; 162(2):1027-1030.
6. Dimick JB Pelz RK Consunji R Swoboda SM Hendrix CW Lipsett PA. Increased resource use associated with catheter-related bloodstream infection in the surgical intensive care unit. Arch Surg. 2001; 136: 229-234.
7. Warren DK Quadir WW Hollenbeak CS Elward AM Cox MJ Fraser VJ. Attributable cost of catheter-associated bloodstream infections among intensive care patients in a nonteaching hospital. Crit Care Med. 2006; 34: 2084-2089.
8. Laupland KB Lee H Gregson DB Manns BJ. Cost of intensive care unit-acquired bloodstream infections. J Hosp Infect. 2006; 63: 124-132.
9. Pronovost P Needham D Berenholtz S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006; 355: 2725-2732.
10. Agency for Healthcare Research and Quality. Ending healthcare-associated infections. http://www.ahrq.gov/qual/haicusp.htm. Accessed November 5, 2012.
11. Berenholtz SM Pronovost PJ Lipsett PA, et al. Eliminating catheter-related bloodstream infections in the intensive care unit. Crit Care Med. 2004; 32: 2014-2020.
12. Pronovost PJ Goeschel CA Colantuoni E, et al. Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: observational study. BMJ. 2010; 340: c309.
13. Lipitz-Snyderman A Steinwachs D Needham DM Colantuoni E Morlock LL Pronovost PJ. Impact of a statewide intensive care unit quality improvement initiative on hospital mortality and length of stay: retrospective comparative analysis. BMJ. 2011; 342: d219.
14. Lin DM Weeks K Holzmueller CG Pronovost PJ Pham JC. Maintaining and sustaining the On the CUSP: Stop BSI model in Hawaii. Jt Comm J Qual Patient Saf. 2013; 39: 51-60.
15. Lin D Weeks K Bauer L, et al. Eradicating central line-associated bloodstream infections statewide: the Hawaii experience. Am J Med Qual. 2012; 27: 124-129.
16. Waters HR Korn R Colantuoni E, et al. The business case for quality: economic analysis of the Michigan Keystone Patient Safety Program in ICUs. Am J Med Qual. 2011; 26: 333-339.
17. Semel ME Resch S Haynes AB, et al. Adopting a surgical safety checklist could save money and improve the quality of care in U.S. hospitals. Health Aff (Millwood). 2010; 29: 1593-1599.
18. Dimick JB Weeks WB Karia RJ Das S Campbell DA. Who pays for poor surgical quality? Building a business case for quality improvement. J Am Coll Surg. 2006; 202: 933-937.
19. Dimick JB Pelz RK, Consunji R., Swoboda SM Hendrix CW Lipsett PA. Increased resource use associated with catheter-related bloodstream infection in the surgical intensive care unit. Arch Surg. 2001; 136: 229-234.
20. Shannon RP Patel B Cummins D Shannon AH Ganguli G Lu Y. Economics of central line-associated bloodstream infections. Am J Med Qual. 2006; 21(6 suppl):7S-16S.
21. Centers for Disease Control and Prevention. Central line-associated bloodstream infection (CLABSI) event. Definition. http://www.cdc.gov/nhsn/pdfs/pscmanual/4psc_clabscurrent.pdf. Accessed November 5, 2012.
22. Ury HK. Efficiency of case-control studies with multiple controls per case: continuous or dichotomous data. Biometrics. 1975; 31: 643-649.
23. Deyo RA Cherkin DC Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992; 45: 613-619.
24. Udpa S. Activity-based costing for hospitals. Health Care Manage Rev. 1996; 21: 83-96.
25. Pham HH Ginsburg PB McKenzie K Milstein A. Redesigning care delivery in response to a high-performance network: the Virginia Mason Medical Center. Health Aff (Millwood). 2007; 26: w532-w544.
26. US Department of Health & Human Services. Audit of the effectiveness of the revised Medicare outlier payment regulation for inpatient acute care hospitals (A-07-04-04032). http://oig.hhs.gov/oas/reports/region7/70404032.pdf. Accessed November 5, 2012.