Abstract
BACKGROUND: Central-line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI) are associated with increased mortality and healthcare costs. We describe implementing a hospital-wide business intelligence (BI) system coupled with infectious disease (ID) specialist intervention to support proactive CRBSI surveillance. METHODS: We conducted a multicenter, retrospective analysis of a quality improvement initiative from January 2019 to September 2024. A BI system used predefined criteria (leukocytosis, elevated C-reactive protein, prolonged catheter duration, and fever) to identify high-risk patients. Starting in July 2022, ID specialists reviewed these cases and provided advice on catheter reassessment. We employed interrupted time series (ITS) analysis to evaluate quarterly trends in CRBSI incidence and mean central venous catheter (CVC) duration, adjusting for seasonality and conducting a stratified analysis for ICU versus non-ICU settings. RESULTS: A total of 5090 patients with 6,750 CVC placements were included. While the overall trend for CRBSI incidence was not significantly affected by the intervention, the stratified analysis showed a statistically significant decrease in the CRBSI incidence trend within the ICU setting (slope change Δ = - 0.737/quarter, P = 0.045). No significant change was seen in the non-ICU setting. The intervention's effect on average CVC duration was less evident, with varied and often non-significant changes across different sites. CONCLUSION: A hospital-wide BI system, combined with ID specialist expertise, was associated with a significant reduction in CRBSI incidence over time, especially in the high-risk ICU setting. This technology-focused, expert-supported approach offers a promising approach to improving patient safety and infection control outcomes.