MGMA of Mississippi - Home - The Core of Outpatient Antibiotic … presentation.… · 2017. 8....
Transcript of MGMA of Mississippi - Home - The Core of Outpatient Antibiotic … presentation.… · 2017. 8....
August 17, 2017
The Core of Outpatient Antibiotic Stewardship
Objectives
• Discuss the CDC’s Core Elements of
Outpatient Antibiotic Stewardship,
• Identify at least one method, for each Core
Element, that can be implemented in your
office practice toward antibiotic stewardship,
• Understand how to develop measures to
track success.
Healthcare-Acquired Infections
MDRO C-Difficile
Imagine
Dirty Wounds:
Immunosuppression
Prophylaxis
Prophylaxis
"The thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant organism."
Alexander Fleming; Nobel Prize 1945
Antibiotic Stewardship
CDC Core Elements of Outpatient Antibiotic Stewardship
• Commitment
• Action for Policy & Practice
• Tracking & Reporting
• Education & Expertise
Commitment
Commitment
• Public displays
– Posters
– Social Media Messages
– Press release materials
– Incorporation into Board and Medical staff meetings
– Web-site banners
https://www.cdc.gov/getsmart/community/materials-references/index.html
• Single Team Leader
– Awareness
– Manager of the implementation
– Watches the data
– Accountable to Sr. Leaders
• Job Descriptions
– Set forth as an expectation of the job
• Evaluations
– Measure specific
expectations
• Communicate with staff
Clinician Checklist
Take Action!
Take Action!
Take Action!
• Communication Skills Training
– Education – Scripting
• Justification documentation
• Clinical Decision support
• Call centers/web communications
– Reduce unnecessary visits, re: colds
Examples of things to measure
• Per physician and
overall
• MACRA measures
Examples of overall measures
% times an antibiotic is prescribed without a
clear indication specified.
% times watchful waiting was implemented
when a patient presents with URI symptoms.
Examples of per physician measures
% times Dr. Z documented a justification for
antibiotic prescription
% times Dr. X used watchful waiting when a
patient presented with URI symptoms.
MACRA measures
• Adult sinusitis
• Children with URI
• Treatment of MSSA
• Acute bronchitis
• Perioperative care: Prophylactic antibiotic
• Total knee replacement
Healthcare Professional Education
Patient Education
• Some infections might improve without antibx
• Serious potential harm
– Allergic reactions,
– C. Diff,
– N/V, diarrhea
– Links to other illness when used in small children
Teach Back
https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2-tool5.html
Stacie Jenkins, RN, MSN Sr. Director of Quality & Patient Safety
318-227-7206 [email protected]
Questions?