Central line-associated bacteraemia (CLAB) is a largely preventable cause of patient harm in intensive care units, yet New Zealand lacked a shared system for measuring infections, learning across sites, or reliably implementing evidence-based practices at a national scale.

Commission & Launch:

• Clinical and system leaders launched a national improvement collaborative, bringing together all adult and paediatric ICUs across New Zealand around a shared aim: reduce CLAB rates to fewer than one infection per 1,000 line days.

Understand the System:

• Teams conducted retrospective audits and examined variation in CLAB rates, revealing inconsistent definitions, uneven data practices, and wide differences in outcomes across units with no mechanism for shared learning.

Focus the Work:

• The network aligned on a small number of high-leverage practices—central line insertion and maintenance bundles—supported by agreed definitions and common measures for improvement.

Generate Ideas for Change:

• Drawing on clinical expertise, international evidence, and local testing, teams identified practical changes to improve reliability, adapting evidence-based bundles to fit diverse ICU contexts.

Learn in Practice:

• Teams tested changes using Plan-Do-Study-Act cycles, supported by national and regional learning sessions, shared data, and peer coaching that accelerated learning across sites.

Sustain and Spread:

• The collaborative established a national CLAB measurement system and reusable regional networks, embedding routines that supported continued learning and sustained performance after the campaign ended.

Through disciplined networked learning, New Zealand’s ICUs achieved substantial and sustained reductions in patient harm while building national improvement capability.

• CLAB rates reduced from 3.32 to 0.28 infections per 1,000 line days (≈90% reduction)

• All New Zealand ICUs participated, with over 90% attendance at national learning sessions

• Improvement sustained, supported by an ongoing national surveillance and reporting system