Antibiotic resistance is an urgent issue that has significant cost and patient outcome implications. A root cause is the systemic overuse and inappropriate use of antibiotics: approximately one out of every two hospitalized patients is administered at least one antibiotic, up to 50% of which are not needed or are not optimally effective as prescribed.
An antimicrobial stewardship program (ASP) that leverages healthtech can help combat this problem. Here are five things the C-suite needs to know:
1. Antimicrobial stewardship saves hospitals money. Numerous studies have shown that implementing an ASP can save both lives and significant healthcare dollars. For example, inpatient antibiotic stewardship programs can improve utilization of antibiotics, improve outcomes and decrease length of stay. ASPs have consistently demonstrated annual savings to hospitals and other healthcare facilities of $200,000 to $400,000, according to the Centers for Disease Control and Prevention. In addition, a University of Maryland study showed that implementation of an antibiotic stewardship program saved a total of $17 million in a span of seven years at a single institution.
2. Standards now mandate that hospitals establish antimicrobial stewardship as an organization priority. The Joint Commission has implemented an Antimicrobial Stewardship Standard, MM.09.01.01, which became effective January 1, 2017. The Centers for Medicare and Medicaid Services (CMS) has also proposed a rule that calls for combined antibiotic stewardship and infection prevention and control programs in all hospitals that receive federal funding, noting that coordinated activities can save $1 billion in annual costs.
3. Front-line clinicians must be engaged with stewardship. Clinicians of all specialties play a primary role in antibiotic prescribing – from the ordering physician to the nurse that hangs the antibiotic. It is critical that they recognize the value they can and should have on stewardship. Rather than telling them what to do and how to do it (which we can all agree will not work), it is important to engage them in the fight to protect patients.
4. Health information technology (IT) is key to fighting antimicrobial resistance. Prescribing variability can be improved by delivering real-time antibiotic insights within a clinician’s existing workflow, and by automatically tracking inconsistencies. By highlighting relevant data that is often buried in the EMR, health IT can help clinicians make more informed antimicrobial choices at the point of prescription. Health IT can also efficiently track clinical and quality indicators through automated reporting and enable hospitals to measure the economic and clinical impact of their stewardship program.
5. Your patients—and your stewardship team—need your help. We know from research and experience that our patients have better outcomes when antimicrobials are used appropriately. Meeting new requirements and impacting the sheer number of antimicrobial prescriptions are simply too much work for a single stewardship pharmacist. Fighting antibiotic resistance is a significant undertaking that requires a team approach, leadership commitment and IT resources, all of which are critical to protecting your patients and your bottom line.
Author: Brandon J. Palermo, MD, MPH, Chief Medical Officer, ILÚM Health Solutions and Executive Director/CMO of Healthcare Services & Solutions (HSS), Merck.
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