Finding Best Practices, Faster

The essential goal of patient-centered outcomes research is to ensure that groundbreaking clinical research leads to rapid dissemination of best practices, so that the best care possible is delivered to patients more quickly at the bedside. It is a tenet of AHRQ’s mission and extends throughout all the areas of research the agency supports.

The Comprehensive Unit-based Safety Program (CUSP) is one area of research that has borne fruit. Its implementation also is an example of a program that was developed with AHRQ funding, implemented on a small scale to test its effectiveness and — once it was shown to work — before widely being extended.

CUSP is a proven method to prevent and reduce healthcare-associated infections (HAIs), especially central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI) and ventilator-associated pneumonia (VAP), which confound the American healthcare system. They are costly, deadly and largely preventable. Since 2008, AHRQ has been promoting the nationwide adoption of CUSP to reduce CLABSI.

CUSP is a multipronged program that promotes a culture of patient safety through improved communication and teamwork among unit staff members, the use of tools such as checklists to support implementation of evidence-based practices for HAI prevention, such as hand-washing and removing unnecessary catheters. A recent report from the ongoing AHRQ-funded project that implements CUSP to reduce CLABSI found these infections were reduced by an average of 33% after one year. 

Its success having been demonstrated, CUSP is being rolled out broadly. Nationwide expansion of CUSP, with its $10 million in fiscal year 2011 funding, has allowed AHRQ to spread the CUSP program to hospitals nationwide, extend it to other settings beyond ICUs and focus on reducing other types of HAIs, such as CAUTI, SSI and VAP. It is taking place through an alliance that consists of AHRQ; the Health Research and Educational Trust, an affiliate of the American Hospital Association; the Johns Hopkins University Quality and Safety Research Group, which developed the CUSP approach; and the Michigan Health and Hospital Association’s Keystone Center for Patient Safety and Quality. To aid its implementation, AHRQ is developing a CUSP toolkit, which will be available in 2012.

Conclusion: Delivering Research Where It’s Needed

AHRQ’s activities are varied, comprising projects in patient safety, patient-centered outcomes research, health information technology, prevention and value. These projects range from small conference grants to large, multistate research projects, yet they all bear a common, unifying theme: the quest to accelerate healthcare quality improvement by putting research into the hands of those who need it.

AHRQ remains committed to its mission of improving healthcare for all Americans. This is broad goal must be achieved one patient at a time. While AHRQ is heavily interested in improving the health of populations, we recognize that healthcare is delivered to individuals. Each patient is different, with his or her own history, circumstances, values, needs and desires. AHRQ remains committed to giving patients and clinicians tools — not rules — to achieve the safest, highest-quality healthcare possible.

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