September 20, 2017
Wyoming Hospital Launches Program to Reduce Antibiotic Resistance
The Memorial Hospital of Sweetwater County has been working on an Antibiotic Stewardship (AS) program that will likely have a positive impact on health outcomes for decades.
Antibiotics have transformed health care to reduce infections that were once lethal. However, 20 to 50 percent of all antibiotics prescribed in U.S. acute care hospitals are unnecessary or inappropriate, according to the Centers for Disease Control and Prevention (CDC). Antibiotics can have harmful effects and can also increase antibiotic resistance in patients – making infections harder to treat and control.
“This definitely has the potential to impact the entire community and overall population health,” said Amanda Molski, the director of quality for Memorial Hospital. “Since it’s a global initiative we are now part of a national movement contributing on a global level. Knowing we are able to contribute to our entire community is very aspiring.”
Background and educational outreach
Memorial Hospital started its AS program in 2016 after knowing it was a national and local need. Once the hospital’s leadership saw value in the initiative, it chose an AS lead to champion the project. The lead is a trained pharmacist versed in AS. The hospital then trained its staff about the importance of AS using materials from the CDC, the Joint Commission’s Speak Up Campaign and Mountain-Pacific Quality Health. Outpatient clinic staff was involved in choosing which handouts and materials they would use for patient education to give them ownership of the program.
To further ownership and buy in from staff on the program, the hospital ordered statement of commitment posters from Mountain-Pacific that described the commitment of the hospital and individual doctors. The posters featured a physician’s picture, signature and hospital logo along with the commitment verbiage. The hospital also included stewardship-related duties in its position descriptions and job evaluation criteria to further its commitment to the program.
With the staff trained and waiting room education materials in place, Memorial Hospital then focused on public outreach aimed at educating its community on the importance of antibiotic awareness. The campaign included radio ads, Facebook posts, the hospital’s website and local newspaper articles. The campaign’s messaging asked patients to inquire if an antibiotic was really needed: “How can you help? When you have a cough, sore throat or other illness, tell your doctor you only want an antibiotic if it’s really necessary.”
Providing prescribing guidelines and next steps
Once the public was touched by the messaging of the campaign, the AS team implemented tools to guide antibiotic prescribing practices. Clinicians at the hospital use evidence-based diagnostic criteria and treatment recommendations to guide decision making through computerized algorithms. Each individual guideline has a reference section where the evidence-based criteria were obtained, giving clinicians the sources of information. The pharmacy team at the hospital is also available for additional support to staff and its patients alike.
One of the steps to reduce antibiotics is to implement the process of delayed prescribing practices and/or watchful waiting, when appropriate. The hospital is in the midst of adopting this process. Clinicians are also slated to receive education and best practices on delaying and watchful waiting practices.
Data will pinpoint the impacts of the program and its results. Memorial Hospital has been diligently working with its information services, pharmacy, informatics, infection prevention, family practice and nursing teams to implement four main goals and measurements to track. Also, the hospital plans to hire a unit pharmacist that will be dedicated to medication reconciliation, medication management, as well as provide provider and patient education in an effective manner.
“It’s definitely an ongoing piece of work, but I think is has been viewed positively,” Molski said. “Our next steps are applying the information and it’s going to take allot of boots on the ground. But I have no doubt our investment in this program will have a lasting impact.”
About Mountain-Pacific—Mountain-Pacific is a 501(c)(3) nonprofit corporation and holds federal and state contracts that allow them to oversee the quality of care for Medicare and Medicaid members. Mountain-Pacific works within its region (Montana, Wyoming, Alaska, Hawaii and the U.S. Pacific Territories of Guam and American Samoa and the Commonwealth of the Northern Mariana Islands) to help improve the delivery of health care and the systems that provide it. Mountain-Pacific’s goal is to increase access to high-quality health care that is affordable, safe and of value to the patients they serve. www.mpqhf.org