Monday, February 22, 2016
United Hospital Fund Works to Tackle Antibiotic Misuse in Outpatient Care
The United Hospital Fund (UHF) announced today the launch of its Outpatient Antibiotic Stewardship Initiative involving hospitals across the metropolitan area in a concerted effort to improve antibiotic-prescribing practices in the community.
Nationally, over 250 million prescriptions for antibiotics are written each year (in all settings), and studies have shown that up to 50 percent of antibiotic use is inappropriate. In March 2015, the Obama administration announced its national action plan on the issue, demonstrating that antibiotic stewardship has become a top federal priority.
Nine New York hospitals and health systems will receive an aggregate $355,780 in UHF grant support for their participation and will bring additional institutional resources to bear on the challenge of developing and implementing successful approaches to antibiotic stewardship.
The initiative aims to identify the factors that drive outpatient antibiotic-prescribing practices and to develop interventions to improve the appropriateness of prescription decisions. UHF will work with a group of 28 hospital outpatient sites—two to five sites per participating hospital or health system—to analyze prescribing practices for adult patients with acute respiratory infections (given national and state data suggesting over-prescription and misuse of antibiotics for those conditions). UHF will create the structure for the initiative and lead learning sessions and webinars, as well as provide technical assistance and access to content experts.
Those receiving grants are Interfaith Medical Center ($30,000), MediSys Health Network ($60,000), Memorial Sloan Kettering Cancer Center ($15,000), Montefiore Medical Center ($35,000), Mount Sinai Health System ($35,180), NewYork-Presbyterian/Queens ($60,000), Northwell Health ($45,000), NYU Langone Medical Center ($45,600), and Wyckoff Heights Medical Center ($30,000).
An advisory group of infectious disease physicians, pharmacists, and outpatient clinicians will work with UHF to develop tools that the participating practices will use to conduct baseline reviews of patient charts and qualitative assessments of antibiotic-prescribing practices. The data will then allow them to develop improvement plans, which they can use to pilot test, implement, and evaluate a proposed intervention. This work will be completed within a year.
“Antibiotic resistance is a growing national concern, and focusing on antibiotic-prescribing practices in outpatient settings offers a unique opportunity to make a difference,” said Hillary Jalon, director of quality improvement at United Hospital Fund. “We hope that our work will shed new light on the topic, create practical tools that providers can use in their practices, and contribute to meaningful change in New York and across the country.”
“We are greatly encouraged by the health care community’s interest in this new work,” said Anne-Marie Audet, MD, vice president in charge of UHF’s Quality Institute. “Despite enormous competing demands for reform initiatives, New York providers are demonstrating their eagerness by engaging in efforts to improve the use of antibiotics. The impact we can have through this collective work could be significant, given the growing problem of drug-resistant bacteria.”
This new work complements that of an existing initiative, the Antibiotic Stewardship Program, which was launched early in 2015 by co-leaders United Hospital Fund and Greater New York Hospital Association and has focused primarily on antibiotic stewardship in the inpatient setting. The initiative is also intended to complement the Get Smart: Know When Antibiotics Work program of the Centers for Disease Control and Prevention, as well as the New York State Department of Health’s efforts.