Download Physician Champion - AIDS Education and Training Centers

12/9/2013
Craig E. Smith, MD, MS, CTropMed, FACP, FIDSA
Medical Director, Infectious Diseases
University Hospital, Augusta, GA
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Antimicrobial stewardship is defined
as a rational, systematic approach to
the use of antimicrobial agents in
order to achieve optimal outcomes.
“Optimal outcomes” include those of the patient
(achievement of cure, avoidance of toxicity and
other adverse effects) and of the larger population
(avoidance of emergence or propagation of
antimicrobial resistance).
Dellit T.H., et al. Clinical Infectious Diseases (2007) 44:159-77
 Monitor antimicrobial prescribing practices
at a health care institution with intervention
as needed.
Results in :
Improve outcomes for individual patients
Optimize treatment of infectious processes
Minimize risk of complications of therapy
Reduce length of stay
Improve outcomes for the larger population
Reduce antimicrobial selection pressure to
limit antimicrobial resistance
 Reduce unnecessary pharmacy expenditures
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Core group of team members:
• Infectious Diseases Physician
or
other interested Physician
• Clinical pharmacist with infectious diseases
training
• Clinical microbiologist
• Infection control professional
Meets weekly for small for rapid cycle changes
• Require the support and collaboration of hospital
administration, medical staff leadership, and local
providers as well as IT support.
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Segmented regression analysis
of interrupted time series data.
MacDougall C , and Polk R E Clin. Microbiol. Rev. 2005;18:638-656
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Key to Success of Program
Engagement: “To involve one-self or become
occupied; to participate fully and deeply”
Respected for leadership and communication skills
and clinical role modeling
Excellent practice outcomes
Passionate/enthusiastic to achieve high quality
performance indicators and process improvements
Tireless
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Willing to devote time, energy and activism to make
changes
Seeks to understand current processes, data and
outcomes
Brings quality improvement skills, vision and
innovation to the table
Operational leader in designing, implementing and
measuring improvement
Secure Medical Staff buy-in and engage
administrative and senior leadership support:
◦ Acceptance of the collaborative CQI project
◦ Resources
◦ Willingness to act upon recommendations
Advocate and reinforce purposes, goals, advantages
of participation and expected results:
◦ Financial incentives; awards, esp. “PFP”
◦ Success with quality audits
◦ Decrease length of stay
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MD
Elements of Honor Roll
Phase 1- Engagement:
1.
Letter of Commitment from Leadership
2.
Antibiotic Stewardship Team
3.
Educational Event
Phase 2- Implementation
4.
Antibiotic Stewardship Programs
5.
Measurement of Impact of Program
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Georgia Honor Roll for
Antibiotic Stewardship
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The Georgia HAI Advisory Committee and Antibiotic
Stewardship Subcommittee have developed an honor
roll program to recognize facilities engaged in
stewardship.
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The requirements of the Honor Roll support the
stewardship principles and tools provided today.
William Osler
1849-1919
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