Preventing bloodstream infections: a measurable national success story in quality improvement.

Over the past decade, advances in the quality of care have been slow. One area of success, however, has been in combating central line-associated bloodstream infections. Data from the Centers for Disease Control and Prevention suggest that the number of patients in US intensive care units suffering a central-line infection declined by 63 percent between 2001 and 2009. We describe the multistep process taken by many stakeholders-states, federal agencies, hospital associations, regulatory and nonprofit associations, clinicians, and local hospitals-to collaborate on the successful reduction and eradication of these infections. Having begun in Michigan, this program has spread to forty-five states, has shown sustained results in reducing hospital-associated infections and mortality, and constitutes an important measurable national success story in quality improvement and a model for improving the health and safety of Americans.