BackgroundAn evidence‐based practice (EBP) approach to implementing change is relevant and pertinent to the strategy to improve outcomes for hospitalized patients with central venous catheters (CVC). As health systems endeavor to achieve the ambitious goals of improving the patient experience of care, improving the health of populations, and reducing the cost of health care, it is imperative to understand the impact of a central line‐associated bloodstream infection (CLABSI) on outcomes.AimsThe purpose of the study was to contribute to the evidence of the association of CLABSI with the outcomes of hospital length of stay (LOS), readmission rates, and mortality rates for hospitalized patients.MethodsA retrospective study was conducted, including all hospitalized patients with a CVC within four hospitals in an integrated health system in northwest Ohio and southeast Michigan. The sample population was stratified into two groups, CLABSI and no CLABSI, and the outcomes of interest for each group were compared.ResultsThe findings substantiate the association between CLABSI and the hospital mortality rate, LOS, and readmission. Patients with a CVC who develop a CLABSI were 36.6% more likely to die in the hospital and 37.0% more likely to be readmitted compared with patients with a CVC who did not develop a CLABSI. In addition, hospital LOS increased an average of 2 days compared with patients without CLABSI. This study evokes implications for EBP change to reduce the rate of CLABSI and for quality improvement during in‐hospital care.Linking Evidence to ActionThere is an association between CLABSI and hospital mortality rate, LOS, and 30‐day readmission outcomes, presenting a profound sense of urgency for EBP change. There were potential variances in processes or practice relative to insertion, maintenance, and removal in the hospitals studied, representing an opportunity to examine the best practices in the hospitals that are performing well. Implementation of EBP requires selecting effective and innovative strategies, with a focus on stakeholder involvement and needs.

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Purpose/Objectives: During the global pandemic of Covid-19, the hospital setting transitional care management was challenged by the complexities of the rapidly changing health care environment, requiring the implementation of an innovative approach to hospital discharge planning. The purpose of this article is to review the experiences of an integrated urban health system, exploring the strategic tactics to ensure effective communication between team members, patient and family engagement in discharge planning, establishing and maintaining trust, connecting patients to appropriate next level of care services, and providing transitional care management support. Primary Practice Settings: The Covid-19 pandemic response stimulated the rapid transformation of the acute care management model amidst the tremendous challenge of meeting the discharge planning needs of the hospitalized population in one large, urban, integrated health care system. Findings/Conclusions: Patients transitioning to the community setting following discharge are vulnerable and at risk for adverse sequelae, and transitional care management that does not end when the patient leaves the hospital setting is integral to promoting positive patient outcomes (Naylor, Aiken, Kurtzman, Olds, & Hirschman, 2011). The care management approach during the pandemic in one health care system precipitously shifted to an entirely virtual, remote model, and the team continued to provide transitional care support for hospitalized patients to avoid the common pitfalls that are associated with unfavorable outcomes. Implications for Case Management Practice: The insights gleaned from one health system's experiences during the pandemic are transferable to other facets of care management in routine circumstances, with emphasis on the avoidance of the common care management snares that lead to less than optimal patient outcomes. The development and implementation of multifaceted interventions, with the goals of supporting health-promoting behavior changes and self-care capacity for at risk populations, are relevant in the current health care environment.

Accountable Care Organizations (ACOs) seeking to decrease health care expenditure may endeavor to decrease the use of institutional postacute care. The implementation of transitional care planning strategies that consider the question, "why not home?" for every patient discharging from the hospital, embraces the spirit of discharging to the least restrictive next site of care. Previous studies indicate that reductions in skilled nursing facility (SNF) spending increase as ACOs mature, partly as a result of efforts to decrease rates of discharge to the SNF setting of care (McWilliams et al., 2017). Claims-based data analyses can be leveraged to inform multifaceted interventions and to inform and drive change. The purpose of this study is to investigate how an intervention to transform the transitional care approach to align with discharging patients to the lowest level of care, as appropriate, impacts patient outcomes.Our previous retrospective cohort study analyzed the association between discharge dispositions of home health (HH) compared with SNF, and the outcomes of readmission rates and cost of care, specifically for Medicare ACO patients discharged from the hospital (Chovanec et al., 2021