How Barnes-Jewish Hospital cut unnecessary UTI testing in half

A simple change to St. Louis-based Barnes-Jewish Hospital's electronic ordering system helped cut the number of unnecessary urine culture tests ordered for suspected urinary tract infections nearly in half, according to a study published Feb. 21 in Infection Control and Hospital Epidemiology.

For the study, researchers from the Washington University School of Medicine in St. Louis implemented several interventions to reduce unnecessary testing for UTIs. In an email to Barnes-Jewish Hospital staff, the researchers encouraged the use of a urine dipstick test to identify signs of infection before ordering a bacterial culture test.

Researchers also modified the hospital's electronic ordering system to include the use of a urine dipstick test as a default before a culture test. In the 15 months before the intervention's implementation, physicians ordered 15,746 urine cultures. In the 15 months after, physicians ordered just 8,823 cultures, which marks a 45 percent decrease and translates to $104,000 in saved laboratory costs.

"Over-testing for UTIs drives up healthcare costs and leads to unnecessary antibiotic use, which spreads antibiotic resistance," senior author David Warren, MD, an infectious disease specialist and professor of medicine at Washington University, said in a press release. "We were able to reduce the number of tests ordered substantially without diminishing the quality of care at all, and at a substantial cost savings."

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