Fewer Catheters, Fewer Infections: Reducing HAIs Through a 'Hospital-wide Huddle'

A Chicago hospital shares insights into a study on how to reduce catheter use, lower acquired infection rates, and engage staff on an interdisciplinary level.

The implementation of a “hospital-wide huddle” at Saint Anthony Hospital successfully reduced the facility’s duration of catheter use and hospital-acquired infections (HAIs) while also earning plaudits from the local medical community.

The Chicago-based hospital was recently recognized by the Illinois Health and Hospital Association (IHA) for its “Innovation Challenge: Partners in Progress Award,” after conducting a study into the reduction of catheter use through hospital-wide participation in a pre-morning meeting.  

Alfredo Mena Lora, MD, medical director of infection control at Saint Anthony, told HealthLeaders Media that the study focused on expanding the scope of the huddle, a common medical practice, to bring everyone on board with the goal of reducing HAIs.

“Ultimately, what’s innovative is that [the study] is hospital-wide, it has infection control variables that can intervene and cause reductions in catheter use, and it’s very cost-effective,” Mena Lora said. “At the end of the day, we’re not buying new equipment, we’re not doing anything other than improving the communication of our existing team members and promoting the reduction of catheters. Because ultimately, if you don’t have catheters, you won’t have infections.”

The study questioned the reliance on central venous and indwelling urinary catheters, and used the daily interdisciplinary safety huddle (DISH) to lower HAI rates. DISH is a 15-minute meeting held in the morning to incorporate participation from a swath of hospital employees ranging from security to nurse managers, emergency services, and infection control.

The hospital instituted a policy for nurse managers to report catheter usage, while an infection control practitioner reviewed indications, duration, and plans for device removal. Any barriers to catheter removal were required to be addressed within 24 hours.

Mena Lora said the accepted definition for HAIs has changed over time, but device utilization rates (DUR) still remain a constant variable for measuring the effects of medical intervention. Using DURs as a stable determinant in the study, Saint Anthony implemented the new policy in late 2014.

Last spring, Saint Anthony reviewed the data from before and after DISH was implemented, which showed a significant decrease in central venous and indwelling urinary catheter use in non-ICU settings.

Prior to the study, there were 12 reported instances of central line-associated bloodstream infections. After DISH was implemented, that number dropped to one case. Similarly, catheter associated urinary tract infections dropped from five reported cases to only one after DISH’s implementation.

Declining DURs led Saint Anthony to see a 90% reduction in HAIs, which resulted in a cost savings of nearly $500,000.

Mena Lora said the experiment displayed clear evidence that without the catheter removal measures put into place, HAI rates would not have declined as precipitously as they did, especially in non-ICU units.

“What that tells us is we did reduce catheter rates across the hospital, and it was statistically significant outside of the ICU,” Mena Lora said. “There were probably a lot of these patients, had there not been DISH, would’ve continued to have these catheters in place without those checks and balances.”