Outpatient Antibiotic Stewardship Initiative

 
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Nationally, studies have shown that up to 50 percent of antibiotic use is inappropriate.

Launched in February 2016, the Outpatient Antibiotic Stewardship Initiative is a United Hospital Fund-led effort involving hospitals across the metropolitan area working together to improve antibiotic-prescribing practices in the community.

Nine New York hospitals and health systems are participating, eight of whom are receiving an aggregate $310,180 in UHF grant support. The participants are also bringing additional institutional resources to bear on the challenge of developing and implementing successful approaches to antibiotic stewardship.

Those participating include Interfaith Medical Center, MediSys Health Network, Memorial Sloan Kettering Cancer Center, Montefiore Medical Center, Mount Sinai Health System, NewYork-Presbyterian/Queens, Northwell Health, NYU Langone Medical Center, and Wyckoff Heights Medical Center.

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 is working with a group of 31 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 data suggesting over-prescription and misuse of antibiotics for those conditions and New York data showing significant variation across the state). UHF is creating the structure for the initiative and leading learning sessions and webinars, as well as providing technical assistance and access to content experts.

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 reviews of patient charts and key informant interviews of antibiotic-prescribing practices, as well as an assessment of current antibiotic stewardship practices implemented in outpatient settings. 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.

This new initiative complements 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.

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.

Contact: Deborah Halper