Two main drivers in healthcare today are improving patient outcomes and reducing cost. These drivers have a tremendous impact on hospital-acquired infections, antibiotic stewardship programs and evidence-based standards of care. As a result, health systems are seeing value in using evidence-based fast susceptibility technology as a more cost-effective way to treat HAIs and improve outcomes.
During an Oct. 24 webinar hosted by Becker's Hospital Review and sponsored by Accelerate Diagnostics™, Russ Nassof, Executive Vice President of RiskNomics, a healthcare environmental risk consulting firm, discussed how using evidence-based fast susceptibility technology can improve antibiotic stewardship programs, thereby improving patient outcomes, minimizing hospital risk and liability, and reducing both cost of care and financial penalties under the ACA.
Moving from customary to evidence-based standards of care
Clinical practice guidelines, evidence-based practice and standard of care are not only medical concepts — they are also legal terms that have become increasingly important in medical malpractice litigation as it applies to new technology.
Fear of malpractice has been a significant barrier to adopting innovative technology. However, Mr. Nassof said changing legal and clinical perceptions of customary versus reasonable care actually encourages physicians to use emerging evidence-based technology to minimize their liability.
Clinical practice guidelines, or customary practice, are patient care recommendations based on a systematic review of medical evidence and published literature. A committee of industry experts periodically updates guidelines in keeping with current research. However, because of the fast pace of medical innovation, CPGs may become invalid or outdated from the time a committee reaches consensus to when guidelines are finally published.
Evidence-based practice, on the other hand, requires clinicians keep informed of emerging best practices based on clinical evidence. Sometimes, evidence-based practice may call for using technology or procedures that aren't yet included in customary practice guidelines.
For this reason, evidence-based practice is becoming the preferred standard of care. In fact, courts have found physician defendants liable of medical malpractice for failure to adopt new technologies or procedures even when near-universal custom did not involve using them, as demonstrated in Washington v. Washington Hospital, Mr. Nassof said.
"Courts have gravitated toward evidence-based medicine by moving in support of the reasonable standard as opposed to the customary standard [of care], because what is reasonable is not necessarily customary," Mr. Nassof said.
Applying evidence-based standards to improve antibiotic stewardship
Hospitals and health systems can use fast susceptibility technology — an evidence-based technology — to improve antibiotic stewardship and mitigate liability by using tailored, narrow-spectrum antibiotics to treat infections.
Overuse of broad-spectrum antibiotics is a driving factor in the growing crisis of antibiotic resistance. Specifically, overuse and overprescribing of broad spectrum antibiotics have been linked to more resistant forms of HAIs, including sepsis and Clostridium difficile.
"Completing the full course of antibiotics was the customary practice, but it may no longer be reasonably prudent, according to technology and research available today," Mr. Nassof said. "So why are we still following the old model when 50 percent of all antibiotics prescribed may be inappropriate? We need to change the messaging by precisely prescribing [antibiotics] for each individual patient, and letting patients know when it's appropriate to stop [the course] when they feel better to decrease antibiotic resistance through overuse."
As an emerging, evidence-based practice, fast susceptibility technology can help minimize antimicrobial resistance by prescribing narrow-spectrum antibiotics for an appropriate period of time. It does this by identifying a specific antibiotic drug and dosage based on each individual patient's culture. More appropriate dosing reduces antimicrobial resistance as well as the potential for HAIs.
Accelerate Diagnostics' fast susceptibility technology generates results on average 40 hours sooner compared to traditional lab methods, completing identification and phenotypic susceptibility analysis in less than seven hours. Faster results provides clinicians with data to make critical-to-life decisions.
"'This is how we've always done it,' are the most dangerous words in healthcare," Mr. Nassof said. "It is the hospital's and physician's responsibility to keep current with scientific developments and evidence-based practice and technology to meet the standard of care. Fast susceptibility technology is an evidence-based standard of care enhancing an organization's antibiotic stewardship program, improving patient outcomes and reducing cost, risk and liability."
To watch a recording of the webinar, click here.