Raising the bar on quality performance in today's hospitals and health systems requires a systematic approach to combatting healthcare-associated infections (HAIs) and antimicrobial resistance. In fact, the two go hand-in-hand.
A focal point of national regulatory movements related to quality improvement, approximately 721,000 avoidable HAIs occur annually, resulting in 7,500 deaths. Misuse of antibiotics significantly contributes to growth of multi-drug resistant organisms (MDROs) such as MRSA, as well as the incidence of other HAIs that currently fall under the scope of value-based performance initiatives laid out by the Centers for Medicare and Medicaid Services.
As the industry continues to make HAI prevention and antimicrobial stewardship a focal point of performance improvement, the role of clinical collaboration is essential to success. Forward-looking hospital and health system executives increasingly recognize the value of taking a multi-disciplinary approach to addressing these area—”where pharmacy and infection prevention expertise is leveraged in a top-of-license manner."
Varying roles, shared mission
Collaborative clinical efforts within an antimicrobial stewardship program (ASP) can help healthcare organizations minimize the potential for avoidable HAIs such as central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), surgical site infections (SSIs) and C. difficile infection. When efforts are coordinated within an ASP to improve the use of antimicrobial agents, clinicians are empowered to make the appropriate choice of drug, regimen, dosing, duration and route of therapy.
While infection prevention and pharmacy are critical to this equation, ASP efforts should engage a broad sample of clinical specialties including nursing, physicians and clinical microbiologists. Ongoing monitoring and analysis of patient outcomes in ASPs allows pharmacists and committees to review policies and increase effectiveness, while improving outcomes. Going forward, this kind of a multi-disciplinary approach is needed to minimize antimicrobial resistance and HAIs, reduce mortality, decrease length of hospital stays and improve the bottom line.
Setting the stage
A culture of collaboration is not achieved in a vacuum. High-performance is achieved through highly-reliable processes that consider:
- The Role of Leadership - Executive, top-down support is critical to setting the tone for ASP performance and expectations. Leaders must purposefully motivate, incentivize and inspire staff to standardize best practices through collaboration.
- Workflows that Support Better Decision Making and Optimize Choices - ASP clinical leaders must set expectations regarding behaviors that align with error prevention through high reliability concepts and evidence-based practices.
- Ongoing Process Improvement - A culture built on transparent collaboration is open to sharing successes and failures and learning from these experiences. Specifically, clinical leaders can leverage root cause analysis methodologies to solve problems and improve quality performance.
The right tools
Advanced clinical surveillance solutions like Sentri7® provide the critical IT support needed to drive programs aimed at optimizing medication management, infection prevention and antimicrobial stewardship. By providing clinical teams with timely, actionable, evidence-based guidance to circumvent potential adverse events, the solution promotes early intervention and appropriate treatment.
Sentri7 aggregates patient data in real-time, automating the tracking, identification and reporting of potential antimicrobial issues. Actionable information built on customized rules prompts clinicians to respond to potential issues. Also, real-time notification of orders for restricted antimicrobials, drug-bug mismatches, renal dosing adjustments, patient allergy or drug-drug interaction risks and prevention of hospital-associated infections ensure rapid, effective response. In addition, the solution:
- Provides actionable, risk-stratified information, drawing attention to urgent issues and the greatest opportunities for improvement.
- Simplifies and significantly reduces time associated with regulatory reporting requirements and streamlines preparation of meaningful reports to highlight performance improvement opportunities.
- Supports clinicians through development of dashboards, clinical rules and reports that automatically fit into daily workflows without the need for IT support.
- Provides actionable, evidence-based information at the point of care that enables clinicians to immediately address issues, optimize quality and deliver consistent care.
A culture of collaboration built on high reliability is best supported with the right infrastructure in place—one characterized by tools and solutions that free up clinicians' time to focus on high-level initiatives.