tals implement computerized doctors-orders systems. But since about 90 percent of American hospitals still don't have such systems, our study suggests that written reminders should be used in their place," says Saint, the director of the UMHS/VA Patient Safety Enhancement Program, which researches ways to prevent patient injuries and adverse events during hospital care. He is also a member of the Patient Safety Committee that oversees clinical patient safety improvement efforts at UMHS.

Ira Strumwasser, Ph.D., president and CEO of BCBSM Foundation, says, "This is a terrific example of how a simple change in a process can make a real difference in lessening the risk of infection for thousands of patients, as well as reduce costs associated with treating infections."

The controlled trial, carried out for 16 months in four wards of the U-M's University Hospital, involved patients who had been admitted for surgery or with general ailments including kidney and lung problems. Two of the wards used the reminder system and two did not, but a nurse checked the records of every patient each day.

The first eight months of the study gathered baseline data on catheter use. Then, for the next eight months on the two wards where reminders were used, the nurse attached a pre-written order and a sign-here sticker to each patient's chart every day after the catheter had been in place for 48 hours. After about four months, she began paging doctors who didn't fill out the order to either continue the catheter or remove it. The medical director of the Infection Control & Epidemiology division, Carol Chenoweth, M.D., began e-mailing doctors as they started their one-month rotations on the wards.

The data were then analyzed and adjusted for the differences in age, sex and length of hospital stay among the patients on the different wards.

In all, the proportion of each patient's hospital stay that involved a catheter went down by 7.6 percent o
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
29-Jul-2005

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