All hospital patients face various life-threatening risks and complications, but most are very rare. Reducing these risks even further is the mission of UAB Medicine Quality.
One example of how this team helps improve quality and patient safety is its recent work to reduce cases of central line-associated bloodstream infection (CLABSI). This rare but serious infection can develop when germs enter the bloodstream through an IV central line.
Team approach
UAB Medicine Quality uses a team approach by operating in triads: a physician, a nurse, and a project manager. They work together to identify risks, analyze trends, and partner with frontline caregivers to ensure that best practices are followed reliably and consistently.
These professionals are data-driven, proactive, and dedicated to continual learning. Their efforts are organized around core “domains”, including safety, mortality, efficiency, equity, and patient-centered care. The CLABSI team leads from the safety domain.
“Quality isn’t just about fixing problems after they happen – it’s about spotting risks and patterns early, before anyone is affected,” said UAB Medicine Associate Chief Quality Officer Kevin Barlotta, M.D. “Our goal is to stop harm before it starts, because every infection we prevent could mean a life saved.”
CLABSI as a priority
A central line is a catheter (tube) inserted into a large vein to provide direct access to the bloodstream. It’s commonly used to administer medications, fluids, and nutrients to patients who are critically ill or need long-term treatment.
CLABSI occurs in a small percentage of patients with central lines but can be very dangerous. It is mostly avoidable if proper steps are taken, so preventing CLABSI is a top priority for UAB Medicine Quality. “CLABSI stood out because we already had proven safety practices in place for it, and we could see that improvements were possible,” said Nisha Washington, Quality project manager and the team’s data lead.
Gathering insight
UAB Medicine Quality uses data to identify improvement opportunities and monitor safety indicators. Central to that approach is partnering with frontline caregivers to better understand the detailed steps involved in delivering patient care.
The team’s CLABSI prevention work followed a structured quality improvement methodology that prioritized input from those directly involved in caring for patients with central lines. From bathing routines and dressing changes to protocols for accessing central line ports, the team gathered insights from units across UAB Medicine to capture the unique aspects of each workflow.
“Collaboration with our frontline teams is paramount, as it allows us to truly understand workflows and challenges and implement proven solutions that directly close safety gaps,” said Jill Stewart, associate vice president of nursing value.
From pilot to practice
In health care, a pilot is a focused way to test standardized approaches in real settings – especially when the opportunity for improvement is clearly visible. In July 2023, Quality launched a pilot across seven UAB Medicine units where central lines are most often used.
It was more than just a test of protocols. The pilot created space for staff to engage with proposed changes, provide feedback, and shape workflow. Partnering with frontline caregivers helped ensure that the updated approach was both clinically sound and operationally practical.
Since the pilot’s completion, the refined practices have been adopted permanently across UAB Medicine. This transition from pilot to practice allowed the team to preserve what worked, fine-tune what didn’t, and support consistent, scalable improvements across a wide range of clinical settings.
Continual improvement
Sustained improvement requires more than protocols – especially in preventing CLABSI. It demands a culture of accountability, shared learning, and continual adaptation. That’s why the team continues to track outcomes, refine strategies, and engage caregivers at every level.
Though specific numbers vary, national CLABSI rates typically range from 0.5 to 2.0 infections per 1,000 central line days. UAB Medicine’s efforts already have led to measurable reductions, reinforcing its reputation for safe, high-quality care.
“We are proud to report that our CLABSI reduction initiative yielded only two documented infections in June 2025,” Dr. Barlotta said. “Even as we recognize this as a single data point in our sustained journey toward eliminating harm, it’s an encouraging milestone that reflects the dedication of our teams.”
These improvements are tracked and reported by organizations such as the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, and Vizient, a health care performance improvement company. More importantly, the improvements benefit every patient who receives safer care.
Stewart put it this way: “If I were in the hospital, I would want to know that someone is looking at the big picture – that people I don’t even see are making sure the care I get is the safest it can be.”
Click here to learn more about the work of UAB Medicine Quality and Patient Safety.