UHF Outpatient Antibiotic Stewardship Initiative

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)
Wyckoff Heights Medical Center ($30,000)

To address the critical issue of antibiotic resistance—to date a focus of work primarily in inpatient settings—by engaging hospital-owned outpatient practice sites in analyzing the factors affecting prescribing practices and developing a comprehensive action plan to test, implement, and evaluate appropriate antibiotic stewardship best practices.

Antibiotic misuse and overuse has emerged as an important health care quality and patient safety issue. Studies show that up to 50 percent of antibiotic prescribing is inappropriate, resulting in increased rates of serious infections and contributing to the spread of antibiotic resistance.

Health care institutions can rely on antibiotic stewardship programs to optimize antibiotic prescribing to improve patient care, reduce costs, and slow the spread of antibiotic resistance. Although antibiotic stewardship practices have predominantly been prioritized within inpatient hospital settings, there is a critical need to consider their applicability in outpatient settings, which is the source of 262.5 million courses of antibiotic prescriptions per year, and where formal stewardship programs are much less common.

Through this grant initiative, United Hospital Fund will work with a group of 24 outpatient sites from 8 hospitals and health systems to better understand the primary factors that drive prescribing practices, and to identify appropriate interventions for the sites to test and implement to improve the appropriateness of antibiotic prescribing. UHF will work with participants to analyze prescribing practices for a sub-set of adult patients with acute respiratory infections, as this is a major condition in which antibiotics are misused. The practices will use a set of structured data collection tools, to be developed by UHF and an advisory group (composed of infectious disease physicians, pharmacists, and outpatient clinicians) that will be formed as part of the initiative. UHF will engage two key infectious disease physicians, from two of the participating hospitals, to provide clinical expertise to help shape this effort.

Feb. 17, 2016