Samaritan’s “HAC Team” Approach Saves Lives & More Than $800,000

Samaritan Health Services reached an impressive milestone this December when the health care system marked a year without a single central line-associated bloodstream infection (CLABSI).

This achievement did not happen overnight. The work started more than three years ago when a multidisciplinary team gathered together at Samaritan to tackle the prevention of two common hospital onset infections.

On top of the dramatic results with eliminating CLABSI cases, these health care professionals’ efforts have also cut catheter-associated urinary tract infections (CAUTIs) to only seven annually in the entire five hospital system. 

These two patient safety achievements are saving both lives and significant health care dollars.

The secret to this success is an innovative team approach called “HAC (hospital acquired condition) teams” that brings together multidisciplinary experts to systematically eliminate preventable harm.

The HAC team concept, which was brought to Samaritan by a former leader, serves as an innovative quality improvement approach with elevated authority to implement a standardized systems approach to eliminate harm.

“The HAC team includes a variety of multidisciplinary subject matter experts,” said Laura Sailor, RN, and quality advisor who co-leads the infection prevention HAC team alongside Melanie Patterson, RN. “You have physician champions, nursing, and multiple other significant team members that are critical to the success of the project.”

For the infection prevention HAC teams, this means bringing together infection preventionists, nurses, physicians, Epic analysts, quality advisors and representatives from all five Samaritan hospital sites. The diversity of perspectives proves crucial to developing solutions that work across different care settings.

At the heart of the HAC team approach is the development of “bundles” — comprehensive recommendations of evidence-based best practices. For catheter-related infections, these bundles cover everything from insertion to maintenance and removal.

The CAUTI bundle, for instance, standardizes sterile insertion techniques, requires two nurses to be present during catheter placement (one performing the procedure, one observing to ensure sterility) and establishes maintenance protocols.

Evidence review revealed that one unit’s practice of cleaning catheters every four hours was counterproductive.

“When we reviewed the literature, it actually says that cleaning too often can create skin breakdown and lead to increased risk of infection,” Patterson said. “The evidence-based guidance now calls for cleaning just once every 24 hours.”

While bundles provide the framework, the real game-changer has been shifting the culture around central and catheter line necessity. Critical questions like these are asked daily during multidisciplinary rounds, which started in the ICU and have expanded to other units.

“What’s really awesome is that a group of multidisciplinary experts are collaborating together in real time to optimize the care of the patient, and get those lines removed as soon as possible,” Sailor said.
“The big questions are, what is the medical necessity for that line? Why today? Do they need this line?”

This daily assessment has dramatically reduced unnecessary line days. Data tracking the standard utilization ratio and comparing actual line days to predicted line days based on patient acuity shows Samaritan has moved from well above expected levels to significantly below them since the HAC teams began their work.

The numbers tell a compelling story. CLABSIs have been eliminated for more than 12 months running with the last case in November 2024. CAUTIs have dropped from 24 events in the year before the program started to just seven this year, which puts the organization on track to achieve a 70% reduction by year’s end.

The human impact is profound. One patient death has been linked to the seven CLABSIs that occurred in previous years, highlighting the life-or-death stakes of infection prevention.

The financial impact is equally striking. By preventing these “never events,” which are infections so preventable that CMS refuses to reimburse hospitals for the associated care costs, Samaritan has saved more than $800,000 so far this year.

Perhaps most encouraging is that Samaritan’s success appears reproducible. Former HAC team members who have moved to other health care organizations have implemented similar processes with comparable results, suggesting this model could transform patient safety industry wide.

During a recent survey at Samaritan Albany General Hospital, according to Patterson they specifically praised the infection reduction achievements as an impressive demonstration of High Reliability Organization principles in action.