Sutter Health Memorial Medical Center Emergency Department

Modesto, California

In 2022 the 43-bed Sutter Health Memorial Medical Center emergency department initiated the Emergency Psychiatric Intervention program geared toward identifying gaps in psychiatric patient medications and encouraging early engagement and de-escalation of violent behavior prior to the patient acting out. With this initiative, there was a reduction of workplace violence injuries within the ED, a reduction in restraint utilization, and increased officer rounding. These initiatives foster more involvement and more thorough psychiatric care, which has contributed to a 12 percent decrease in WPV injuries in the ED from 2022 to 2023.

The ED also worked to reduce catheter-associated urinary tract infections by forming a multidisciplinary CAUTI Reduction Team to report data trends, collaborate on process improvement implementation from ED arrival through the inpatient units, and improve insertion techniques. Immediate collection of urine post-insertion allowed for tracking of patients with an indwelling Foley catheter. Reevaluating the indications for insertions while in the ED helped reduce Foley catheter insertions and tracking data on patients who had Foley catheters placed helped determine the ultimate need for placement. This data assisted in process changes of inserting a straight catheter over indwelling foley catheter for this specific patient population. Since 2022 CAUTI rates have decreased by 86 percent.