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The Comprehensive Unit-based Safety Program (CUSP)

CUSP is a five-step program designed to change a unit’s workplace culture—and in so doing bring about significant safety improvements—by empowering staff to assume responsibility for safety in their environment. This is achieved through education, awareness, access to organization resources and a toolkit of interventions.

Adopted by about 40 units at The Johns Hopkins Hospital—and hundreds of units outside of Hopkins—CUSP has been used to target a wide range of problems: patient falls, hospital-acquired infections and medication administration errors, to name a few.

This five-step program has also provided a framework to get units involved with, and committed to, organization- and national-level safety goals. In fact, CUSP was used by more than 100 intensive care units in the State of Michigan in their much-heralded work to drastically reduce central catheter-related bloodstream infections

CUSP works because it recognizes the central importance of culture in sustainable patient safety improvements. A unit’s safety culture can reliably predict a wide range of complications and infections, as well as such operational outcomes as nurse turnover. Because culture is local, it must be targeted at the unit level, with support at the organizational level.

The Center for Innovation can help your hospital to introduce CUSP and turn it into a potent tool for improvement. Contact us to learn more about our CUSP services.

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The Center for Innovation is now part of the new Armstrong Institute for Patient Safety and Quality. Learn more about the institute.


Please review training opportunities at the Armstrong Institute for a listing of upcoming workshops and online programs.

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