Welcome to the SUCCESS Project

Background

Although infections related to urinary catheters are getting more attention due to public reporting and hospital penalties, there is less recognition that noninfectious complications related to the trauma of catheter placement and removal are as common as urinary tract infections – and often have long-lasting consequences for patients with abnormal bladder emptying and discomfort. Furthermore, we have heard from surgeons that – while urinary catheter overuse and injury are problems – the most common problem they see in their practices is urinary retention, and they have expressed interest in guidelines or pathways to guide the management of this common problem.

After being funded by an Agency for Healthcare Research and Quality (AHRQ) grant, the Surgical Urinary Catheter Care Enhancement Safety Study (SUCCESS) was developed and led by Dr. Jennifer Meddings to improve the safety of perioperative urinary catheters, by reducing catheter use and catheter-associated complications, and improving postoperative urinary retention management. This work complements current CAUTI surveillance measures.

A team of researchers, MSQC, and other clinicians designed variables for EHR abstraction in the MSQC database with a goal of measuring perioperative urinary catheter use and duration, urinary catheter-related injury/trauma, and urinary retention, including management, risk factors, and triggers for catheter use in cases of retention, focused on adults undergoing General Surgery procedures: appendectomy, cholecystectomy, colorectal surgery, and hernia repairs. With 13 MSQC pilot hospitals in 2021, the new variables were tested in the MSQC database and definitions were revised for clarity.


SUCCESS Introduction video

Toolkit Implementation

Better tools are needed to measure and reduce perioperative urinary catheter use, as well as manage postoperative urinary retention and urinary catheter-associated complications.  A comprehensive toolkit will be developed, implemented, and evaluated in collaboration with a pilot group of MSQC hospitals’, surgeons, and nurses. The novel measures and toolkit could dramatically reduce common, costly, and morbid complications related to perioperative urinary catheter use, adaptable to many other surgical procedures, to improve the safety of our most vulnerable patients.

The toolkit intervention will address clinician knowledge and urinary catheterization skills, as well as communication and implementation challenges anticipated to impact catheter use in different types of perioperative clinical settings. This intervention aims to reduce inappropriate perioperative urinary catheter use, catheter associated complications including infections and catheter-associated trauma, and improve management of postoperative urinary retention.


Data Abstraction and Quality Improvement

Prior to the data abstraction, training is required. Please contact Jessica Ameling at jameling@med.umich.edu if you would like information about SUCCESS data abstraction or if you would like to participate in Cohort 2 training that begins in June 2022.

Hospitals capturing SUCCESS data in the MSQC database in 2022 are eligible to select the potential 2023 SUCCESS Quality Improvement project. We have developed a Value Proposition presentation to help engage support for the project from hospital leadership, frontline providers, and other stakeholders.


Need more information?

Please contact Jessica Ameling at jameling@med.umich.edu if you would like more information or if your hospital would like to participate in the SUCCESS project.