United Hospital Fund, Seven Hospitals Expand Efforts to Improve Antibiotic Prescribing for Outpatients in New York City

NEW YORK, NEW YORK, April 26, 2017—United Hospital Fund (UHF) announced today that it is launching Stage II of its Outpatient Antibiotic Stewardship Initiative to improve antibiotic prescribing for outpatients across New York City, working with seven hospitals and health systems encompassing 36 outpatient practices.

In Stage I of the Outpatient Initiative, started in February 2016 with $310,000 in UHF funding, data was collected from 31 clinics across nine health systems in New York City, revealing considerable variation in prescribing practices for adult patients with acute respiratory infections (ARIs), even within a single health system. UHF has committed an additional $300,000 to Stage II of the Initiative, which will build on this data to develop best practices for antibiotic use for ARIs.

Participants in Stage II are Medisys Health Network, Memorial Sloan Kettering Cancer Center, Montefiore Medical Center, Mount Sinai Health System, NewYork-Presbyterian Queens, NYU Langone Medical Center, and Wyckoff Heights Medical Center.

“It is widely acknowledged that many health care systems do not have strong outpatient antibiotic stewardship activities, even when robust inpatient programs exist,” said UHF President James R. Tallon, Jr. “Stage II of the Outpatient Antibiotic Stewardship Initiative represents the commitment of UHF and its clinical partners to make New York a national leader in improved outpatient prescribing practices.”

The data in Stage I revealed that use of antibiotics for acute respiratory infections, which frequently resolve without antibiotics, averaged 37 percent, ranging from a low of approximately 17 percent to a high of about 71 percent. Using these findings as a starting point, activities during Stage II will include:

Identifying clinical champions at each clinic site to drive practice change
Formalizing provider education regarding appropriate prescribing practices
Developing specific tools such as best-practice advisories for use with electronic medical records
Implementing monthly site-specific and provider feedback
Implementing patient education on appropriate use of antibiotics
Incorporating additional practice sites not included in Stage I
"We are very encouraged that the participants in Stage II of UHF's Outpatient Antibiotic Stewardship Initiative are committed to investigating, examining, and improving their own practices, setting a standard for other health systems to follow,” said Deborah Halper, UHF vice president for education and program initiatives.

The Outpatient Initiative grew out of UHF's Antibiotic Stewardship Program, created in 2015 in partnership with Greater New York Hospital Association to address improper use of antibiotics in the inpatient setting.

More than 250 million prescriptions for antibiotics are written each year across the United States, and the Centers for Disease Control and Prevention (CDC) has found that up to 50 percent of those medicines are used inappropriately, which can lead to antibiotic resistance. Drug-resistant bacteria are responsible for at least 2 million infections in the United States each year, resulting in an estimated 23,000 deaths. In March 2015 the Obama administration announced a National Action Plan for Combating Antibiotic-Resistant Bacteria and made antibiotic stewardship a top federal priority.

Besides expanding the Antibiotic Stewardship Program, Stage II is also intended to complement the CDC's Get Smart: Know When Antibiotics Work program and New York State Department of Health efforts.

About United Hospital Fund

United Hospital Fund works to build a more effective health care system for every New Yorker. An independent, nonprofit organization, we analyze public policy to inform decision-makers, find common ground among diverse stakeholders, and develop and support innovative programs that improve the quality, accessibility, affordability, and experience of patient care. For more on our initiatives and programs please visit our website at www.uhfnyc.org and follow us on Twitter.

April 26, 2017
Focus Area
Quality and EfficiencyClinical-Community Partnerships
Quality Institute