Premier hospitals take on infections

Data-driven fight begins with goal to cut overuse of antibiotics
By Bernie Monegain
10:22 AM
Medical research

Fifty hospital and health system members of Premier across 24 states are testing, defining and scaling new strategies in a nationwide effort to combat antibiotic-resistant bacteria.

The goal is to reduce antibiotic overuse by 20 percent and implement the Centers for Disease Control's core elements of its antibiotic stewardship program by July 2016.

The data-driven performance improvement collaborative is applying insights based on research Premier and the CDC published last year, which revealed the use of unnecessary and duplicative intravenous antibiotics, and pointed the inappropriate usage to 23 IV antibiotic combinations.

The collaborative will focus first on the combination with the most opportunity for reduction based on individual hospital data. They will also work to implement at least three of the CDC's core elements for antibiotic stewardship programs.

[See also: Healthcare steps up to superbugs.]

"Patient harm from hospital-acquired infections and adverse drug events, antibiotic resistance and excess costs can all be serious consequences of inappropriate antibiotic therapy," said Dayna McManus, infectious diseases clinical pharmacy specialist at Inova Fairfax Medical Center, which is part of the collaborative. "In joining this effort, we will work with fellow Premier member hospitals to share data and define evidence-based practices, pinpoint opportunities for improvement and assess our progress in reducing antibiotic resistance."

The antibiotic stewardship collaborative supports the National Action Plan for Combating Antibiotic-resistant Bacteria, which Premier committed to support, including its goals to establish:

  • Antibiotic Stewardship Progams in all acute care hospitals by 2020; and
  • Benchmarks to reduce antibiotic use by 50 percent in outpatient settings and 20 percent in inpatient settings by 2020 

"Recognizing the growing threat of infections and other microorganisms becoming resistant to antimicrobial agents, Premier and the CDC worked together to identify specific areas in care where potential antibiotic overuse is the highest," Gina Pugliese, RN, vice president of the Premier Safety Institute, said in a news release. "These leading hospitals are leveraging this research to target and implement real-world change, as well as share lessons learned, metrics developed and best practices gleaned from the collaborative that will serve to broadly inform healthcare providers."

Antibiotic stewardship collaborative participation is exclusive to members of Premier's QUEST quality improvement collaborative. All QUEST hospitals use analytics powered by the PremierConnect performance improvement platform, including tapping analytics to improve resource utilization and eliminate unjustified variation in care delivery.

PremierConnect Safety clinical surveillance analytics help providers monitor and protect patients from infections, harmful drug interactions and other adverse events. These solutions help providers leverage timely and actionable data for rapid care interventions, and insights into trends to drive antibiotic stewardship techniques into patient safety practices. In addition, QUEST's social community in the platform enables real-time member interactions.

[See also: Premier makes big connect with big data.]

Up to half of patients treated in the U.S. receive unnecessary or inappropriate therapy, including multiple antibiotics when using just one antibiotic or no antibiotic would be the best approach, according to the CDC. Sometimes in an effort to 'do whatever it takes' to fight a serious infection, clinicians use multiple antibiotics to treat the same infection.

These practices have contributed to a worldwide increase in antibiotic-resistant bacteria.

Two million people are infected with antibiotic-resistant organisms nationwide each year, resulting in approximately 23,000 deaths annually and excess healthcare costs as high as $20 billion per year.

[See also: Two dead, 179 exposed to superbug at UCLA Medical Center.]