4/28/17. New Jersey Antimicrobial Stewardship Learning Action Collaborative. Antimicrobial Stewardship Efforts in New Jersey. Update May 10, 2017

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1 New Jersey Antimicrobial Stewardship Learning Action Collaborative Update May 10, 2017 Antimicrobial Stewardship Efforts in New Jersey Acute Care Hospitals Outpatient Settings (ED, physician practices) Long Term Care Facilities Source: PfP pacing event, Sept,

2 Reduce Harm Across the Board Support hospitals to work on all 11 core areas of harm Adverse drug events (ADE), to focus on at least the following three medication categories: opioids, anticoagulants and hypoglycemic agent Central line-associated blood stream infections (CLABSI) Catheter-associated urinary tract infections (CAUTI) Clostridium difficile (C. diff) bacterial infection, including antibiotic stewardship Injury from falls and immobility Pressure Ulcers Sepsis and Septic Shock Surgical Site Infections (SSI) Venous thromboembolism (VTE) Ventilator-Associated Events (VAE) Readmissions Collaborative Leadership Administrative Leadership: NJHA Institute for Quality and Patient Safety Aline Holmes, DNP, MSN, RN Shannon Davila, MSN, RN, CIC, CPHQ Lauren Rava, MPP Clinical Leadership: Kennedy Healthcare Cindy Hou, DO, MBA, FACOI Marianne Kraemer, RN, MPA, ED. M., CCRN David Condoluci, DO, MSc., and MACOI Partners New Jersey Department of Health QIO- Healthcare Quality Strategies Inc. CDC Ernest Mario School of Pharmacy Ronald G Nahass, MD, MHCM President ID Care Quality Insights Renal Network 3 New Jersey APIC chapters Alex T. Makris, MD, CMD Collaborative Mission To promote the use of the appropriate agent, dose, duration, and route of administration of antimicrobial agents across the continuum of care to improve quality of patient care and patient safety while reducing excessive costs 2

3 NJHA Antimicrobial Stewardship Collaborative 36 months, beginning in January 2017, and ending in December 2019 Content will be delivered through learning sessions led by expert faculty and peer-to-peer sharing Monthly Webinars and multiple in- person learning sessions A combination of outcome,process, and antimicrobial use metrics will be collected to measure progress Collaborative Goals By the end of 2019 the collaborative participants will demonstrate 100% implementation of all seven CDC core elements of antibiotic stewardship Establish a statewide baseline antimicrobial use rate Opportunities for Improvement 3

4 Does your facility have a policy that requires prescribers to document in the medical record or during order entry a dose, duration, and indication for all antibiotic prescriptions? 80.6% 19.4% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Is there a formal procedure for all clinicians to review the appropriateness of all antibiotics 48 hours after the initial orders (e.g. antibiotic time out)? 80.6% 19.4% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% CDC seven core elements of antibiotic stewardship Leadership Commitment: Dedicating necessary human, financial and information technology resources; Accountability: Appointing a single physician leader and a single nurse leader responsible for program outcomes; Drug Expertise: Appointing a single pharmacist leader responsible for working to improve antimicrobial use; Action: Implementing policies and interventions to improve antimicrobial use, such as systemic evaluation of ongoing treatment need after a set period of initial treatment (i.e. antibiotic time out after 48 hours); Tracking: Monitoring antimicrobial prescribing and resistance patterns; Reporting: Regular reporting information on antimicrobial use and resistance to doctors, nurses and relevant staff; Education: Educating clinicians about resistance and optimal prescribing. 4

5 Tiered Approach to Implementation of Practices Antimicrobial Use Data New Jersey Antimicrobial Stewardship Learning - Action Collaborative Resources Shannon Davila RN, MSN, CIC, CPHQ Director, Institute for Quality and Patient Safety, NJHA sdavila@njha.com Lauren Rava, MPP Project Coordinator, NJHA lrava@njha.com