This action guide contains the stories of four hospitals that have applied a patient safety model called the Comprehensive Unit-based Safety Program, or CUSP, to dramatically reduce central line-associated bloodstream infections (CLABSIs) and other health care-associated infections (HAIs). Many have heard about what CUSP is through two highly publicized demonstrations funded by the Agency for Healthcare Research and Quality (AHRQ)—the Michigan Keystone intensive care unit (ICU) project, begun in 2004, and the national On the CUSP: Stop BSI project begun in 2008. These case studies illustrate how actual hospitals have applied CUSP to improve care. Each story is unique and detailed. We use quotations extensively because they give a human face to the principles and practices at the heart of the CUSP. The cases address the origins of each facility's journey to eliminate HAIs, the organizational processes put into place, how CUSP champions overcame resistance and promoted ownership and accountability, and how CUSP is being sustained in units and spread into other areas of the hospital. One story demonstrates how easily CUSP was integrated with another quality improvement method.
There are many more examples of hospitals successfully using CUSP, and we hope to highlight some of them in the future.
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