AUA 2024: Clear Urinary Tract Infection Protocol Improves Urology Staff and Provider Satisfaction

( On Friday, May 3rd, 2024, at the American Urological Association’s annual meeting, the Quality Improvement and Patient Safety session included a presentation by Dr. Sabrina Stair, describing her group’s experience in developing a streamlined approach for acute urinary tract infection (UTI) patient inquiries in an ambulatory urology setting.

Dr. Stair began by describing the scope of the issue that sparked this quality improvement initiative. She reviewed that the management of UTIs represents a significant clinical challenge and economic burden, consuming approximately $1.6 billion in healthcare resources annually. A considerable portion of these infections can be classified as uncomplicated UTIs, which ideally should be managed in primary care or urgent care settings to optimize resource utilization and patient outcomes. However, distinguishing between uncomplicated and complicated UTIs has often proven problematic for clinical staff, leading to unnecessary delays and inefficiencies in patient care. To address these issues, Dr. Stair and colleagues implemented a streamlined protocol for handling acute UTI inquiries in an ambulatory urology clinic. This initiative was designed to improve the efficiency of patient inquiries management, thereby increasing staff and provider satisfaction while ensuring patients receive timely and appropriate care.
a streamlined protocol for handling acute UTI inquiries in an ambulatory urology clinic
The cornerstone of this initiative was the development of a clear and systematic approach to directing patient inquiries regarding acute UTI symptoms. Dr. Stair outlined that the new protocol included detailed guidelines on how office staff should direct patients to the appropriate care pathways, depending on the complexity of their symptoms. A significant educational component was also involved, where staff were trained on the differences between uncomplicated and complicated UTIs and how to apply the new algorithm effectively. Pre- and post-implementation surveys were conducted to assess the impact of the new protocol on staff and provider satisfaction as well as on the clarity of communication processes within the clinic. The surveys, utilizing a Likert scale ranging from 1 (least satisfied/clear) to 5 (most satisfied/clear), demonstrated a marked improvement in both satisfaction and clarity post-implementation. 

Following the implementation of the protocol, the average satisfaction score among staff and providers increased significantly from 2.3 to 4.1, while clarity scores rose from 1.9 to 4.2. Moreover, the average number of messages related to acute UTIs received per week decreased substantially from 14.1 to 4.8, with a p-value of 0.04, suggesting a significant reduction in unnecessary communication and an increase in workflow efficiency.

Dr. Stair emphasized that these findings underscore the potential benefits of implementing clear, structured protocols in clinical settings, particularly in specialties like urology where timely diagnosis and treatment are critical. This successful implementation serves as a model for other clinical settings experiencing similar challenges, highlighting the importance of clear guidelines and education in optimizing clinical workflows and resource utilization. Such initiatives not only support the delivery of timely and appropriate care but also contribute to the overall satisfaction of both healthcare providers and patients, ultimately leading to improved health outcomes and reduced healthcare costs.

Presented by: Sabrina Stair, MD, Virginia Mason University, Seattle, WA

Written by: Ruchika Talwar, MD, Urologic Oncology Fellow, Vanderbilt University Medical Center, during the 2024 AUA Annual Meeting, San Antonio, TX, May 3rd to May 6th