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Celebrate TOH’s 12 Big Ideas

At TOH, we never stop looking for innovative ways to improve the delivery of patient care. We constantly seek new ways to make the hospital experience of our patients and their families easier and more compassionate. In fact, we’re recognized leaders on many fronts.

As 2013 came to a close, we highlighted 12 game-changing ideas – we’re calling them “Big Ideas” – that have improved patient care or experience at TOH. Here is the next Big Idea: Use a checklist to reduce urinary tract infections.

What’s the Big Idea?

Urinary tract infections (UTIs) from catheter use are probably the most common hospital-acquired infection. To help reduce the UTI rate in patients, the Department of Medicine has developed a checklist for doctors to guide them on when it’s appropriate to order a catheter. The project will also monitor the rates of UTIs before and after the checklist was introduced to judge its effectiveness. Research elsewhere has shown that the checklist helps reduce catheter-related UTIs.

“Most hospital-acquired UTIs are preventable,” said Dr. Krista Wooller, a general internist who worked with Dr. Delvina Hasimja on the initiative. “Catheters are often used because they make it easier for care teams to take urine samples from very sick patients, monitor their fluid output and allow frail patients who can’t get out of bed easily to empty their bladders. If the catheters are left in place too long, they become portals for bacteria, leading to infection. The checklist reminds the care team to use catheters only when needed.”

What’s the impact on patients?

Seven out of 10 patients in general medicine wards are elderly and have cognitive impairments and multiple chronic illnesses such as heart failure and diabetes. UTIs can increase their risk of further physical and cognitive decline, and trigger delirium, especially in patients with early-stage dementia.

Fewer UTIs mean less antibiotic use, lower rates of bed sores, higher rates of mobility and shorter hospital stays for patients.

Why should you care?

Fewer UTIs mean improved patient care. Also, patients who contract UTIs stay in hospital, on average, 1.5 days longer, which increases TOH’s costs significantly.

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