Telligen Outpatient Antibiotic Stewardship Initiative. The Renal Network March 1, 2017

Transcription

1 Telligen Outpatient Antibiotic Stewardship Initiative The Renal Network March 1, 2017

2 Who is Telligen? What is the QIN-QIO Program? Telligen: The Medicare Quality Innovation Network (QIN)-Quality Improvement Organization (QIO) for Colorado, Iowa and Illinois QIN-QIO Program Purpose: To improve the efficiency, effectiveness, economy, and quality of services delivered to Medicare beneficiaries 2

3 Objectives Discuss antibiotic use and resistance in dialysis clinics Review the goals for Outpatient Antibiotic Stewardship Review CDC Outpatient Antibiotic Stewardship Core Elements Discuss the opportunity to participate with Telligen 3

4 What is Antibiotic Stewardship? Antibiotic stewardship is an effort to improve: Antibiotic prescribing by clinicians Antibiotics are only prescribed when needed Ensure right drug, dose, and duration are prescribed Use of antibiotics by patients Patient is receiving optimal treatment Patients understand clinician instructions for use 4

5 Why is Antibiotic Stewardship Important for Dialysis Centers? High use of antibiotics in patients receiving hemodialysis Increased risk of healthcare-associated infections More than 70% of bacteria that cause healthcare associated infections are resistant to at least one of the drugs used most commonly to treat them Overuse of antibiotics lead to the emergence and spread of multidrug resistant organisms 5

6 Adverse Outcomes Side effects Rashes, skin reactions Severe allergic reaction, anaphylaxis Diarrhea Toxicity (kidney, liver) Resistant organisms Increased possibility of hospitalization Increased morbidity and death Increased cost 6

7 Antibiotic Use in Dialysis Centers Most commonly prescribed antibiotics: Vancomycin Cefazolin Third or fourth generation cephalosporins Approximately one third of antibiotic use in dialysis centers is inappropriate! 7

8 Inappropriate Antibiotic Use Antibiotics given when conditions for an infection were not met (52.9%) Failure to use a more narrow-spectrum antibiotic (26.8%) Antibiotic given when indication for surgical prophylaxis not met (20.3%) 8

9 9 Addressing Antibiotic Stewardship in Dialysis Centers

10 Core Elements of Outpatient Antibiotic Stewardship Commitment: Demonstrate dedication to and accountability for optimizing antibiotic prescribing and patient safety. Action for policy and practice: Implement at least one policy or practice to improve antibiotic prescribing, assess whether it is working, and modify as needed. Tracking and reporting: Monitor antibiotic prescribing practices and offer regular feedback to clinicians, or have clinicians assess their own antibiotic prescribing practices themselves. Education and expertise: Provide educational resources to clinicians and patients on antibiotic prescribing, and ensure access to needed expertise on optimizing antibiotic prescribing. 10

11 Telligen s Outpatient Antibiotic Stewardship Initiative Partner with outpatient providers 11 Emergency department Health clinics Physician offices Dialysis Clinics Assist with the implement of the CDC s Core Elements Assess current program Assist to enhance or strengthen program Provide technical assistance and resources Free educational webinars and conferences Networking opportunities Ongoing support

12 Challenges Dialysis Centers Face Order for antibiotics come from outside the dialysis center Limited resources 12

13 What is the benefit to you? Meets Merit-Based Incentive Payment System (MIPS) improvement activity criteria Eligible activity to avoid negative payment penalty in 2017 Medium weighted activity worth up to 20 points of the 40 point requirement Focused assistance and resources at no cost Reduce preventable adverse drug events at your facility Stewardship practices are transferable to other 13 medication safety principles

14 Next Steps to Begin Implementing Antibiotic Stewardship 1. Sign and submit a commitment form 2. Complete a brief Telligen Antibiotic Stewardship Assessment 3. Complete short assessment 4. Participate in Telligen offered educational webinars, technical assistance, resources and tools 14

15 Contacts To learn more contact: Jenny Winkler, MPH, CIC, MLS(ASCP) Gina Jones, MPS This material was prepared by Telligen, the Medicare Quality Innovation Network Quality Improvement Organization, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW-IL-C /24/