Using Agile Science to Implement Alternatives to Indwelling Urinary Catheters

Area of Science:

• Healthcare Management
• Infection Prevention and Control
• Agile Methodologies in Healthcare

Background:

• Inconsistent adoption of alternatives to indwelling urinary catheters (IUCs) hinders catheter-associated urinary tract infection (CAUTI) reduction.
• External urinary devices offer a viable alternative to reduce CAUTIs.

Purpose of the Study:

• To accelerate the implementation of external urinary devices across a large hospital network using an Agile Science framework.
• To optimize the adoption and sustainability of IUC alternatives for CAUTI prevention.

Main Methods:

• Utilized an Agile Implementation process with multidisciplinary teams to co-design iterative
• sprints
• targeting EMR changes, auditing, education, and workflow integration.
• Monitored process measures (learning module completion, audit compliance) and outcome measures (CAUTI Standardized Infection Ratio [SIR], indwelling catheter Standardized Utilization Ratio [SUR]).

Main Results:

• Successfully pivoted from daily to risk-based audits, achieving 99%-100% compliance.
• Increased learning module completion from 34% to 99% within 18 months.
• Achieved a 36% reduction in network CAUTI SIR, reaching 0.52 by Q3 2025, and sustained SUR below the national median.

Conclusions:

• Agile Implementation's iterative approach and feedback mechanisms were crucial for adapting interventions and ensuring success.
• Rapid adoption of IUC alternatives, supported by integrated systems and risk-based auditing, can lead to meaningful CAUTI reductions and promote sustainability.