Nicklaus Children's Hospital Leads as Innovator in APP International Quality Improvement Project on Managing Infants and Children with Urinary Tract Infections

Published on: 11/20/2015
MIAMI -- Nicklaus Children’s Hospital, part of Miami Children’s Health System, is among 42 hospitals involved in an international improvement collaborative for infants and children hospitalized with their first urinary tract infection. The program is led by the American Academy of Pediatrics (AAP). 

Urinary tract infections are the most common serious bacterial infections in infants and young children, affecting 2 percent to 5 percent of all children. 

“At Nicklaus Children’s, we are committed to providing the best care possible. Our participation in the project will help optimize care practice and results for the large number of young children we treat with urinary tract infections,” said Dr. Veronica Etinger, a pediatric hospital medicine specialist, who is leading the project at Nicklaus Children’s Hospital.

In September 2011, the AAP published a clinical practice guideline to aid in the diagnosis and management of urinary tract infections. The guideline helps doctors and other healthcare providers make more accurate diagnoses, avoid unnecessary painful imaging studies, avoid prolonged intravenous antibiotics, and curtail the use of preventative antibiotics which contribute to bacterial resistance. 

As in many areas of medicine, uptake of new guidelines is slow, and individual practitioners face logistical and cultural barriers to changing long-standing practice, even when new evidence suggests a better way. The goal of this project, Quality Improvement for the Management of Children Hospitalized with Urinary Tract Infection, or Q-UTI (pronounced cutie), is to address those barriers. The project will be conducted by the Value in Inpatient Pediatrics Network, a program of the AAP Quality Improvement Innovation Networks.

Q-UTI, like previous Value in Inpatient Pediatrics Network projects, provides content and quality improvement expert guidance within a low-cost virtual learning collaborative, leveraging health information technology and the Academy’s data aggregator. 

“We believe that providing multi-disciplinary teams with quality improvement education tools specific to urinary tract infections and the opportunity to collaborate in learning and implementation will increase compliance with the evidence-based guideline, and thereby decrease overuse of non-evidence based therapies and tests” said Q-UTI project leader Richard Engel, MD, FAAP.  

The specific aim of the project is to improve care for children 7 days to 24 months of age who are hospitalized with a UTI in the domains of diagnostic strategy, imaging, and treatment based on the recommendations in the 2011 AAP clinical practice guideline, as well as other relevant clinical evidence. This project will also offer American Board of Pediatrics Maintenance of Certification Part 4 credits to physicians who meet the qualifying criteria. 

Resources and strategies developed as part of the project will be available through the Academy’s Quality Improvement Innovation Networks Network website, a clearinghouse of information and resources for quality improvement, at 

For more information about Nicklaus Children’s Hospital visit
About the AAP
The American Academy of Pediatrics is an organization of 64,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit
About QuIIN/VIP Network
The Quality Improvement Innovation Networks (QuIIN) is home to multiple pediatric quality improvement networks designed to improve care for children and their families in both the inpatient and outpatient settings. QuIIN serves as the infrastructure for pediatric improvement networks by providing staff, financial, and standard operating systems to the Value in Inpatient Pediatrics (VIP) Network and the Practice Improvement Network. The VIP Network, the inpatient network of the QuIIN, is a healthcare stewardship organization which improves the value of care delivered to any pediatric patient in a hospital bed by helping providers implement clinical practice guidelines and other best practices, with a special focus on eliminating harm and waste caused by overutilization.
About Nicklaus Children's Hospital

Founded in 1950 by Variety Clubs International, Nicklaus Children's Hospital is South Florida's only licensed specialty hospital exclusively for children, with nearly 800 attending physicians and more than 475 pediatric subspecialists. The 309-bed hospital, known as Miami Children's Hospital from 1983 through 2014, is renowned for excellence in all aspects of pediatric medicine with many specialty programs routinely ranked among the best in the nation by U.S. News & World Report since 2008. The hospital is also home to the largest pediatric teaching program in the southeastern United States and has been designated an American Nurses Credentialing Center (ANCC) Magnet facility, the nursing profession's most prestigious institutional honor. For more information, please visit

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