Improving Care Using Frontline Action Teams: Reducing UTI at Langley Memorial Hospital Sherman Bastarache Amanda Bordt November 16, 2012

LMH and NSQIP Joined NSQIP in July 2011 NSQIP module: procedure targeted 33 surgical beds Team recruitment started in January Team Action started April 2012

Goal and the Stats Team Goal To reduce the catheter-associated urinary tract infection rate to 2% (from 3.4%) by October 1, 2012 in surgical patients at Langley Memorial Hospital

Gyne perineal Prep

Stopped Routine Catheterization of Total Joint Patients

Total Joint Foley insertion Guideline Criteria to insert Indwelling Foley Catheter in Total Joint Patients Criteria to insert Indwelling Foley Catheter in Total Joint Patients Procedures expected to last longer than 5 hours Procedures expected to last longer than 5 hours Total Hip replacements patients who meet 1 (one) of the following criteria: Total Hip replacements patients who meet 1 (one) of the following criteria: -Over the age of 80 -Over the age of 80 -Obesity (BMI > 40) -Obesity (BMI > 40) -urinary incontinence or history of urological issues / medications -urinary incontinence or history of urological issues / medications -Determined necessity by the surgeon -Determined necessity by the surgeon Total Knee replacement patients who meet 1 (one) of the following criteria Total Knee replacement patients who meet 1 (one) of the following criteria -Over the age of 75 -Over the age of 75 -ASA III or greater -ASA III or greater -Obesity (BMI >40) -Obesity (BMI >40) -Urinary incontinence or history of urological issues / medications -Urinary incontinence or history of urological issues / medications -Determined necessity by the surgeon -Determined necessity by the surgeon

Audits and Huddles

New Catheter Kit

Physician Reminder Sticker This patient has an indwelling urinary catheter This patient has an indwelling urinary catheter  Remove indwelling urinary catheter  Maintain indwelling urinary catheter Signature: __________________ Signature: __________________

Goal and the Stats Team Goal To reduce the catheter-associated urinary tract infection rate to 2% (from 3.4%) by October 1, 2012 in surgical patients at Langley Memorial Hospital A decrease of 0.6% so far, which translates to 17 UTI’s prevented!!!!!

Contact Information Sherman Bastarache Amanda Bordt Veronica Mills Mohammad Amanda Crowe SCR: Lila Denise QI: Michael Arget Manager: Kendalll Korda: Surgeon Dr. Mitra Champion FHA: