The White House, the National Quality Forum and many other groups have spoken out and formed initiatives or coalitions to bring attention to the mounting problem of antibiotic-resistant bacteria. At the U.S. News Hospital of Tomorrow conference in Washington, D.C. Monday, a group of panelists weighed in on what hospitals and infection preventionists can do to be a part of the solution.
Panelists included Marci Drees, MD, hospital epidemiologist and infection prevention officer for Christiana Care Health System in Newark, Del., Brad Spellberg, MD, CMO for Los Angeles County and the University of Southern California Medical Center, and Arjun Srinivasan, MD, associate director for healthcare associated infection prevention programs in the division of healthcare quality promotion at the CDC.
Here are five elements that should be part of an effective antibiotic stewardship program, according to the panel discussion.
• The healthcare industry needs to focus on doing things very differently than it has in the past to control antimicrobial resistance. This is because the actions providers take now in how they distribute and administer antibiotics will affect how useful they are in the future.
• Using metrics to track how a hospital improves over time is crucial in determining which practices are most effective. The same goes for comparing hospitals' data against one another.
• One of the biggest contributors to over-prescribing is the choice many physicians make to administer antibiotics as a kind of failsafe, recommending them to patients as a precautionary measure without confirmation that pathogenic bacteria are the root cause of an ailment.
• A hospital's leadership's commitment to a stewardship program goes a long way toward ensuring success. This includes providing the tools for appropriate antibiotic tracking, designating a single pharmacy leader, educating physicians and encouraging regular reporting on usage. Currently, 40 percent of hospitals meet these standards. The CDC hopes to have that number rise to 95 percent by 2020.
• The types of interventions a hospital includes in its programs should streamline workflows, not make it more difficult for frontline care team members to perform their duties.