MetroHealth System Implements Zero-Tolerance Policy for Healthcare-Associated Infections, Aims for 75% Reduction by 2026
CHICAGO, March 15, 2025 – MetroHealth System announced today the adoption of a system-wide zero-tolerance policy for healthcare-associated infections (HAIs), establishing what executives call the most aggressive infection prevention framework in the organization’s 40-year history. The policy, effective immediately across 12 hospitals and 28 outpatient facilities, requires mandatory compliance with evidence-based prevention bundles and establishes direct financial penalties for units failing to meet performance benchmarks.
The initiative comes as HAIs continue to affect approximately one in 31 hospitalized patients on any given day, according to the Centers for Disease Control and Prevention (CDC), with an estimated 687,000 infections occurring annually in U.S. acute care hospitals . Despite national progress that saw significant decreases in central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) between 2022 and 2023, MetroHealth leadership determined that incremental improvement was insufficient.
“For too long, our industry has accepted HAIs as an unfortunate cost of providing complex care,” said Dr. Sarah Chen, MetroHealth’s Chief Executive Officer. “This policy declares that every single preventable infection is one too many. We are embedding accountability into our operating model, not just our mission statement.”
The zero-tolerance framework centers on 12 evidence-based intervention bundles targeting CLABSI, CAUTI, surgical site infections (SSI), ventilator-associated events (VAE), and Clostridioides difficile transmission. Each hospital unit must demonstrate 95% compliance with insertion and maintenance protocols, including hand hygiene, chlorhexidine bathing, daily device necessity reviews, and environmental cleaning audits. Unit managers and clinical directors face performance-based compensation adjustments tied directly to infection rates, with quarterly reviews determining incentive eligibility.
CMS penalties provide additional motivation. Under the Hospital-Acquired Condition (HAC) Reduction Program, hospitals ranking in the worst-performing quartile for infection measures face automatic 1% payment reductions on all Medicare claims . MetroHealth projects its initiative will generate $4.2 million in annual cost avoidance by preventing approximately 180 infections system-wide, based on average per-case treatment costs of $23,000.
Leadership commitment drives the cultural shift required for sustained improvement, research indicates. Successful “Target Zero” programs require strategic planning, open communication channels, and treating every infection as potentially preventable through root-cause analysis . MetroHealth has established a system-level Infection Prevention Governance Council with authority to mandate protocol changes and allocate resources across facilities. The council includes representation from medical staff, nursing, environmental services, and supply chain management.
Education and competency validation form the policy’s foundation. All 8,400 clinical staff must complete specialty-specific training modules and pass performance assessments by June 2025. The system implemented unit-based safety coaches empowered to stop procedures if practitioners deviate from established protocols, mirroring successful interventions that achieved 66% CLABSI reductions in multicenter studies. Real-time electronic surveillance flags high-risk patients and device-days, triggering automated prevention checklists in the electronic health record.
Preliminary data from pilot units shows promise. Two intensive care units at MetroHealth’s flagship hospital have maintained zero CLABSI events for 127 consecutive days since protocol implementation. System-wide hand hygiene compliance increased from 71% to 94% through direct observation and covert monitoring technologies.
“These results validate that zero tolerance is not aspirational—it’s achievable when evidence-based practice meets unwavering accountability,” said Dr. Michael Torres, Chief Medical Officer. “Our patients deserve nothing less than our absolute commitment to keeping them safe from harm while under our care.”
The policy aligns with the World Health Organization’s principle that “No one should get sick seeking care” . While acknowledges that absolute zero presents challenges, Hospital System Implements Zero-Tolerance Policy for Healthcare-Associated Infections a senior official said the target functions as both measurable goal and cultural philosophy, driving continuous improvement even if perfection remains elusive.
About MetroHealth System
MetroHealth System operates 12 acute-care hospitals, three long-term acute care facilities, and 28 outpatient centers across Illinois and Indiana. The not-for-profit academic health system includes 2,100 licensed beds, admits more than 95,000 patients annually, and serves as a primary teaching affiliate for Northwestern University Feinberg School of Medicine. Recognized by The Joint Commission for excellence in patient safety, MetroHealth maintains accreditation as a Comprehensive Stroke Center and Level I Trauma Center. For more information,
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