The Obama Administration convened a White House Forum on Antibiotic Stewardship June 2, bringing together key constituents involved in antibiotic stewardship, including several hospitals and health systems from around the country, as well as constituents from food companies, retailers and the animal health industry.
Highlighted below are what five of those hospitals and health systems are doing to combat the growing problem of antibiotic resistance in the healthcare setting.
1. Ascension Health (St. Louis). This system plans to establish facility-based antimicrobial stewardship programs at all of its hospitals and adopt the Centers for Disease Control and Prevention's Core Elements of Hospital Antibiotic Stewardship Programs. Ascension will also submit antibiotic use and resistance data to the CDC and evaluate facility antibiograms.
2. Carolinas HealthCare System (Charlotte, N.C.). CHC has an Antimicrobial Support Network, a six-hospital stewardship program that helps healthcare providers make better decisions for the selection, dosage and duration of antibiotic treatments for patients. The system recently committed to spreading the ASN to include 13 inpatient and rehabilitation facilities by the end of 2015. Additional efforts include:
- Implementing stewardship programs at all CHC inpatient locations within three years, including required antibiotic use reporting,
- Developing and implementing stewardship programs for skilled nursing facilities and outpatient care practices over five years,
- Incorporating antibiotic indicators and duration reminders into the EMR, and
- Developing care pathways for specific diseases including best practices for antibiotic prescribing
3. HCA Healthcare (Nashville, Tenn.). This for-profit system plans to develop new clinical decision support and real-time antibiogram tracking to respond to lab results and catch bug-drug mismatches, among other efforts.
4. Intermountain Healthcare (Salt Lake City). Intermountain plans to reduce inappropriate outpatient antibiotic use for upper respiratory conditions by 50 percent by 2020. All system hospitals will have stewardship programs in place by the end of 2017, and Intermountain will support telemedicine efforts to extend the reach of infectious disease experts out into rural settings.
5. Kaiser Permanente (Oakland). Kaiser will guide antibiotic prescribing practices at all of its hospitals with electronic alerts and order sets.