Spotlight On: King Faisal Specialist Hospital & Research Centre: Getting to Zero CLABSI

King Faisal Specialist Hospital & Research Centre (KFSH&RC) is located in Saudi Arabia, with centers in Riyadh and Jeddah, the two largest cities on the Arabian peninsula.  Offering a wide range of medical services, KFSH&RC treats thousands of patients every year — making it one of the premier health care providers in the Middle East.  As such, KFSH&RC is dedicated to improving safety in their hospitals in order to raise the bar and improve the quality of care for their patients.

KFSH&RC recently announced a partnership with the Patient Safety Movement Foundation to reduce the incidence of central line-associated blood-stream infections or CLABSI.  More specifically, KFSH&RC committed to reduce CLABSI over the next three years.

Regarding King Faisal Hospital’s goal to reduce CLABSI, PSMF recently spoke to the KFSH&RC Quality Management Team at King Faisal Hospital in Riyadh.  KFSH&RC Riyadh is trying to create a framework for people to take a look at near misses in CLABSI.  Many times, clinicians are focused on specific challenges, but the Quality Management Team at KFSH&RC believes clinicians must look at how they handle safety in general.  That’s why they have launched the Zero CLABSI project at the Riyadh campus.

Read on for PSMF’s discussion with KFSH&RC Riyadh to learn more about this commitment and the steps that the hospital center is taking to reach their Zero CLABSI goal.

PSMF: Please tell me about the commitment you made to PSMF.  What was it?

KFSH&RC: We started this project in January 2018 to achieve the goal of zero CLABSI.  More specifically, this commitment is to reach zero CLABSI over a period of three years.  The CLABSI project is a high-level aim, and the results are monitored very closely and available on a dashboard that is open to all hospital employees.  Our goal is a reduction of 20% over the first year, 30% reduction in the second year, and 50% in the third year. 

PSMF: What prompted this commitment?

KFSH&RC: Due to the increase in the level of CLABSI cases in the hospital, the hospital administration decided to go into a high level data driven quality aim to reduce the implication of CLABSI infection on our patient and also to decrease the cost  associated with this infection.

PSMF: What steps did you take to achieve this commitment?

KFSH&RC: We developed a multifaceted plan to tackle this goal.  First, we put together a high level multidisciplinary team with all subject matter experts (intensivist, nursing, quality, patient safety, infection control, product coordination, etc.).  Each harm event gets reviewed, validated, and analyzed.  We use specific Root Cause Analysis to systematically review harm events.  The collaborative team reviews the harm events and ongoing actions to ensure progress towards our Zero CLABSI goal.  We monitor established indicators, provide intensive education for healthcare providers handling central lines, and develop change ideas that cover all aspects of central line insertion, maintenance, and removal.

PSMF: In what ways has education helped you progress towards Zero CLABSI?

KFSH&RC: We have used different educational methods to ensure progress towards our goal.  More specifically, we use various methods of education including simulations, coaching, and hand hygiene campaigns.

PSMF: What are the key indicators you consider in your goal of  Zero CLABSI?

KFSH&RC: We look at the number of CLABSI incidents, and both the number of and percent of CLABSI Insertion Care Bundle Compliance.  We have outlined key drivers in order to implement relevant change ideas and measure success via these indicators.  

PSMF: What are the most important aspects of this commitment that have contributed to the success of your hospital in achieving improved patient safety?

KFSH&RC: The most important aspects of our commitment have been: a) training new residents and fellows on proper technique for inserting lines; b) introduction of antimicrobial impregnated central lines; c) implementation of automated central lines infection control and preventions bundle; d) unifying hospital policies and procedures for central line insertion, maintenance, and removal.

PSMF: What do you like best about the commitment you have made with PSMF?  Conversely, what is the most challenging part about it? 

KFSH&RC: The best part about the commitment we have made with the PSMF is that it has encouraged the team to work hard to achieve a targeted, significant improvement.  We have also been met with some challenges, however.  Specifically, there are certain patient populations who are incontinent who can easily contaminate the lines.  We also are working to improve compliance with hand hygiene to prevent the spread of infection all over the hospital.  Finally, we are experiencing noncompliance with septic techniques while handling the central lines from some health care providers.  This all makes achieving our goal difficult, but awareness of the challenges will help us implement changes that can help us gain maximum compliance on the road to zero CLABSI. 

PSMF: How has COVID-19 affected your progress towards this goal?

KFSH&RC: COVID-19 has changed day-to-day lives of people around the world, and of course, in the hospital setting, it is no different.  We have implemented strict measures to prevent the spread of COVID-19 in our hospital and research center.  Unfortunately, these measures have made it difficult to operate normally to achieve our goals of Zero CLABSI.  We have delayed team meetings and important follow-ups on major change ideas, and some important team members in our goal of Zero CLABSI have been locked down during the COVID-19 pandemic.  This makes it difficult to move forward, but we are taking it one day at a time and hoping to return to normal again.

PSMF: That seems to be the case worldwide.  On a more positive note, how many lives have you saved since implementing this commitment?

KFSH&RC: Since implementing our Zero CLABSI goal, we have saved 50 lives from the baseline in 2017.

Read more about King Faisal Specialist Hospital & Research Centre – Riyadh’s commitment to Zero CLABSI here.