title: A Single-Center Multidisciplinary Initiative to Reduce Catheter-Associated Urinary Tract Infection Rates: Quality and Financial Implications.
abstract: BACKGROUND
  Catheter-associated urinary tract infection (CAUTI) is an important patient safety issue that is responsible for an estimated 449334 annual infections, with an average direct cost of $790-$1200 per infection. In total, the cost associated with CAUTI is estimated to be $115 million to $1.82 billion annually.
  
  
  METHODS
  We conducted an internal revenue analysis with a standard sensitivity analysis to assess the impact of a low-cost CAUTI reduction program on direct costs to the hospital over four years. The interventions included the formation of a multidisciplinary CAUTI reduction task force, formal data collection in all ICUs, staff education, and new electronic order sets with decision support.
  
  
  RESULTS
  During the initial intervention period, the infection rate per 1000 catheter days decreased from 5.4 to 1.5. In the second year of the program, the infection rate increased to 4.6. After additional interventions were launched, infection rates decreased to 2.2. Cost savings per 1000 catheter days (±20%) during the initial intervention were $4501 ($3600-$5401).
  
  
  CONCLUSIONS
  Our intervention demonstrated that provider education and electronic documentation prompts were followed by a significant decrease in catheter utilization, that in turn was followed by lower infection rates. Decreased emphasis on intervention goals were followed by an increase in CAUTI rates. Our subsequent interventions suggest that upward trends may be reversible.
authors.affiliation: Author Affiliations: Department of Anesthesia, Critical Care and Pain Medicine (Sutherland), Beth Israel Deaconess Hospital, Boston, Massachusetts; Department of Quality and Safety (Mss Beloff and McGrath, and Drs Pimentel, Kachalia, and Bates), Brigham and Women's Hospital, Boston, Massachusetts; Division of General Medicine (Ms Liu, and Drs Bates and Kachalia), Brigham and Women's Hospital, Boston, Massachusetts; and Department of Anesthesiology, Perioperative and Pain Medicine (Drs Urman and Pimentel), Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Tori
authors.initials: T
authors.lastname: Sutherland
authors.forename: Jennifer
authors.initials: J
authors.lastname: Beloff
authors.forename: Casey
authors.initials: C
authors.lastname: McGrath
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Liu
authors.forename: Marc T
authors.initials: MT
authors.lastname: Pimentel
authors.forename: Allen
authors.initials: A
authors.lastname: Kachalia
authors.forename: David
authors.initials: D
authors.lastname: Bates
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D055499:Catheter-Related Infections / Q000191:economics / Q000517:prevention & control*; D017046:Cost Savings; D020000:Decision Support Systems, Clinical; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000592:standards; D033183:Interdisciplinary Communication; D061214:Patient Safety; D058996:Quality Improvement / Q000191:economics*; D014552:Urinary Tract Infections / Q000517:prevention & control*