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

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

3. 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

4. Gyne perineal Prep

5. Stopped Routine Catheterization of Total Joint Patients

6. 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

7. Audits and Huddles

8. New Catheter Kit

9. 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: __________________

10. 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!!!!!

11. Contact Information Sherman Bastarache sherman.bastarache@fraserhealth.ca Amanda Bordt amanda.bordt@fraserhealth.camanda.bordt@fraserhealth.ca Veronica Mills veronicamills@fraserhealth.ca Mohammad Khaligh-Razavimohammad.khaligh-razavi@fraserhealth.ca Amanda Crowe amanda.crowe@fraserhealth.ca SCR: Lila Gottenboslila.gottenbos@fraserhealth.calila.gottenbos@fraserhealth.ca Denise Sherbandenise.sherban@fraserhealth.cadenise.sherban@fraserhealth.ca QI: Michael Arget michael.arget@fraserhealth.ca Manager: Kendalll Korda: kendall.korda@fraserhealth.cakendall.korda@fraserhealth.ca Surgeon Dr. Mitra Maharajmitra.maharaj@fraserhealth.camitra.maharaj@fraserhealth.ca Champion FHA: ACS.NSQIP@fraserhealth.ca