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Research Letter
May 9, 2011

The Ability of Intensive Care Units to Maintain Zero Central Line–Associated Bloodstream Infections

Author Affiliations

Author Affiliations: Departments of Health Policy and Management (Drs Lipitz-Snyderman, Goeschel, Marsteller, Berenholtz, and Pronovost) and Biostatistics (Dr Colantuoni), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Pulmonary & Critical Care Medicine and Department of Physical Medicine and Rehabilitation (Dr Needham), Quality and Safety Research Group (Drs Goeschel, Marsteller, Thompson, Berenholtz, Lubomski, and Pronovost), and Department of Anesthesiology and Critical Care Medicine (Drs Goeschel, Marsteller, Thompson, Berenholtz, Lubomski, and Pronovost), Johns Hopkins University, Baltimore; Johns Hopkins School of Nursing, Baltimore (Drs Goeschel and Pronovost); and Michigan Health & Hospital Association, Lansing (Mr Watson).

Arch Intern Med. 2011;171(9):856-858. doi:10.1001/archinternmed.2011.161

Central line–associated bloodstream infections (CLABSIs) are common, costly, and largely preventable and are a target of many recent national initiatives.1-3 One common method of reporting performance is the duration of time without infection,4 a simple technique used for motivating sustained improvement. Despite evidence demonstrating reduced infection rates from evidence-based interventions for CLABSIs, the field has not yet defined the attainable duration of time hospitals can go without a CLABSI. Without understanding “best achievable” time without any infection, hospitals may anchor themselves, and public expectations, to suboptimal performance. Such data are required to establish performance benchmarks that represent best practices, create realistic public expectations, motivate internal improvement efforts, and design fair pay-for-performance policies.