AHRQ Safety Program for Improving Antibiotic Use Ambulatory

AHRQ Safety Program for Improving Antibiotic Use Ambulatory Care

Presenter – Jeff Linder • Jeffrey A. Linder, MD, MPH, FACP • Professor of Medicine and Chief, Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine • Project email address: antibioticsafety@norc. org

What Is the AHRQ Safety Program? • Collaborative intervention – AHRQ – Johns Hopkins Medicine – NORC • Overarching goals – Assist outpatient practices with reducing unnecessary antibiotic use – Enhance teamwork and communication around the diagnosis and treatment of infections and antibiotic prescribing – Improve patient safety and safety culture – Assist practices with enhancing workflow, especially during the busy cold and flu season – Maintain and improve patient satisfaction 3

Participating in the AHRQ Safety Program • 1 -year program begins in December 2019 • FREE to participate • Open to the following types of practices taking care of adults or children: Primary care practices Urgent care clinics Community-based health clinics Specialty medical practices that provide primary care – Student health clinics – – • Electronic health record (EHR) required • Continuing medical education (CME) credits for physicians, physician assistants, and nurse practitioners • Maintenance of Certification (MOC) available for physicians 4

Educational Content • Access to infectious disease and primary care experts for coaching and troubleshooting • Monthly interactive Webinars – 20 minutes long – Recorded and posted to the program Web site for 24/7 access – Slides and facilitator guides available for local use • Office hours – Optional calls for additional assistance – Once a month • Audio presentations 5

Webinar and Audio Presentation Topics • • Why Your Practice Should Focus on Antibiotic Use and How Your Practice Is Doing With Antibiotic Prescriptions Communicating With Your Patients What Can You Learn From Your Antibiotic Prescription Data? The Never Diagnoses: Upper Respiratory Tract Infections The Never Diagnoses: Influenza The Never Diagnoses: Acute Bronchitis The Sometimes Antibiotics Diagnoses: Otitis Media The Sometimes Antibiotics Diagnoses: Sinusitis and Pharyngitis • • • Usually Antibiotics Diagnoses: Community-Acquired Pneumonia Developing a Consensus in Your Practice Around Symptomatic Treatment of Respiratory Tract Infections Antibiotic Allergies: What Can You Actually Use? Cellulitis and Skin Abscesses Asymptomatic Bacteriuria and Urinary Tract Infection Sustaining Antibiotic Stewardship Efforts 6

More Benefits of Participating • Additional educational content – Pocket cards and one-page documents that summarize existing knowledge and recommendations for common conditions for which antibiotics are prescribed in the outpatient setting – Educational material for patients and families – Commitment posters • Quarterly data benchmarking reports • Assistance with meeting the CMS MIPS requirements and demonstrating compliance with the new Joint Commission Ambulatory Antimicrobial Stewardship Standard • Certificates of participation in the AHRQ Safety Program for Improving Antibiotic Use 7

Four Moments of Antibiotic Decision Making 1. Does my patient have an infection that requires antibiotics? 2. Do I need to order diagnostic tests? 3. If antibiotics are indicated, what is the narrowest, safest, and shortest regimen I can prescribe? 4. Does my patient understand what to expect and the followup plan? 8

What Do Participating Practices Need To Do? • Identify a clinician and administrative lead • Participate in Webinars and audio presentations • Work with your practice to identify areas to improve antibiotic prescribing and incorporate proposed changes into clinical practice • Submit requested data to the program Web site • Time commitment: – 3 hours per month • 1 hour on Webinars and/or audio presentations • 2 hours on local, collaborative meetings to translate the content from the Safety Program into practice at your site, and calling into Office Hours 9

Data Required From Participating Practices 1. Monthly data on patient visits 2. Monthly data on number of antibiotic prescriptions, by antibiotic 3. Monthly data on number of patients with respiratory infections (certain ICD-10 codes) 4. Monthly data on number of patients with a respiratory condition and prescribed antibiotics Data collection period: 9/2019– 12/2020 13

Other Data Required From Participants • Structural assessment at the start and end of the Safety Program • Medical Office Survey on Patient Safety (MOSOPS) at the start and end of the Safety Program 16

Timeline for Participation September 2019 – November 2019 December 2019 – November 2020 Identify clinical and administrative Participate in educational programs leads within your ambulatory care including the onboarding/orientation practice Webinar series, audio presentations, and educational Webinars Complete Ambulatory Care Team Regularly meet as a team to Letter of Commitment implement interventions and monitor performance Register your team to use the program Web site/data portal Collect and submit data 18

Safer Health Care for Current and Future Generations 13

To Learn More and Enroll • Visit our Web site: • https: //safetyprogram 4 antibioticstewardship. org/ • Complete the online application on the Web site • Email antibioticsafety@norc. org with any questions 14

Questions 1. Type in your questions using “Chat” or 2. Speak up on conference line THANK YOU FOR PARTICIPATING! 15