Catheter-associated urinary tract infections (CAUTIs) are common, reasonably preventable sources of patient harm. Recently, AHRQ has funded the national On the CUSP: Stop CAUTI project, with the goal of reducing CAUTIs in participating hospitals by 25%. This article describes the substantial efforts of this collaborative in engaging states and hospitals to successfully implement interventions that reduce catheter use and associated infections. Currently more than 800 hospitals are participating, with the expectation that this number will exceed 1000 and the initiative will spread to all 50 states by the end of the project. The authors suggest that this experience may serve as a model for other large, national improvement efforts to address hospital-acquired conditions. A prior AHRQ WebM&M interview with Dr. Sanjay Saint, the senior author of this article, discussed CAUTI prevention.