Background Healthcare-associated infections are a problem for the Swedish healthcare system. In order to reduce the risk of acquiring healthcare-associated infections, the intensive-care unit attended a breakthrough project in 2004–2005, with the aims of studying methods of increasing patient safety and systematically improving treatment outcomes. The intensive-care unit had no system for registering infections, and the authors wanted to ascertain the prevalence of healthcare-associated infections, and register and prevent them.

Objectives 40% reduction in healthcare-associated infections in ventilated patients. 100% of staff to implement basic hygiene routines.

Design The method used was the Breakthrough Series, originally designed by the Institute for Healthcare Improvement in Boston, Massachusetts, USA. The method aims to bridge the gap between what is known and what is done, spreading best-practice methods even faster. Many ideas for changes are tested on a small scale, with the basic rule that the small changes combine to create large changes that lead towards the final goal.

Results The frequency of healthcare-associated infections in ventilated patients was reduced by 43%. Compliance with the basic hygiene routines improved greatly, from 72% on initial measurement to 98% today.

Conclusion In order to reduce the risk of acquiring healthcare-associated infections and to increase patient safety, a continuous, systematic effort involving continual measurement and review is necessary.