Management of Acute Cystitis

Team, 

During the 8 weeks of this project, TAUC has delivered care to  1,641 patients diagnosed with urinary tract infection or dysuria. Through your phenomenal efforts, we have amassed very helpful data and shown significant improvement in several categories.

The chart review component of the project evaluated patient charts for the content of HPI, exam, culture utilization, and prescribing practices to give each patient encounter an overall “effective care score” based on current guidelines. I completed chart reviews for 1,551 patients, and we increased the effective care score from a baseline of 63.88% to 78.45%. This was just under the initial research target of 80%.

The algorithm tool was returned a total of 792 times, and 478 of these met the inclusion criteria for the project. 

As the project progressed, the algorithm was used significantly less; however, aggregate data showed an inverse improvement of the appropriate culture usage from a baseline of 61.68% during the first cycle to 76.42% by the end of the project. Hopefully, this reflects a permanent improvement in our culture ordering habits. 

Prescribing practices are where we made the most impact. At baseline, our prescribing accuracy, a composite score based on guideline suggested duration, dose, and frequency, was 76.92%. By the last cycle, this had improved to 95.54%. The total score across all four phases of the project was 89.15%, just under the 90% goal. Aggregate data analysis also revealed that dosing durations improved dramatically from phase 1, where duration was 19.23% (295 days) over the guideline recommendations to  just 4.08% (114 days over) during phase 4. 

Finally, congratulations to Jae Williams, who again turned in the most algorithms during the fourth and final phase of this project. She earned another $40.

The grand prize winner ($100) is Ryan Schaeffer! He turned in 28 algorithms that met inclusion criteria during the project. Runners up were Kelli Rosen with 24, Yoav Kadan with 23, and Jerry Shen with 20. 

Thank you to all of you who took the time to complete these forms and impact the outcome of the project. The winners of each phase were:

• 1/14-1/25: Ryan Schaeffer          

• 1/26-2/8:  Jae Williams

• 2/9-2/22:  Ryan Schaeffer

• 2/23-3/8:  Jae Williams

• Grand prize: Ryan Schaeffer

I have tremendous  admiration for the care you deliver to our patients daily. Not only do you continue to impact those we serve, but you have also impacted me and helped to push me to my goal of completing this doctoral project. Without the encouragement I received from you, the challenge of the project may have become insurmountable.

I am honored to work with each of you.

Jenn O’Donnell FNP-C