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The Steward-Ship Laveer

AMS Laveer 690 px

October, 2017

AHOY Idaho and Washington Participants!  Welcome to the inaugural launch of our (mostly) monthly newsletter about the Antimicrobial Stewardship in Outpatient Settings Initiative. We hope to keep these check-ins brief, but to also bring useful information to your growing AMS Programs – and resources to help you sail to your destination of meeting all four of CDC’s Core Elements of Antibiotic Stewardship.

Through the Porthole – Your Monthly Resource

This month’s AMS resource highlight comes from the Washington State Department of Health – who recently completed a series of Clinical Practice Guidelines to assist outpatient healthcare providers and ambulatory clinics optimize antibiotic use to achieve the best outcomes for patients, and prevent antibiotic resistance.

This month we will  focus on Adult Uncomplicated Bronchitis Clinical Practice Guideline.  This recommendation is in alignment with national standards and provides excellent information on symptoms and diagnosis, conditions to rule-out, non-antibiotic treatment options and best practices for communicating with patients.

Washington State Department of Health: Clinical Practice Guidelines for the Judicious Use of Antibiotics
Acute Uncomplicated Bronchitis

Another nationally recognized resource with focus on condition, diagnosis and treatment is the CDC Adult Treatment Recommendations:

Centers for Disease Control and Prevention: Adult Treatment Recommendations – for Outpatient Healthcare Professionals

Both of these guidelines are in alignment with the Infectious Disease Society of America guidelines

*TIP*  In an effort to meet the “ACTION” Element – you can discuss with your providers the current evidence-based, best practices surrounding diagnosis and treating bronchitis. If you then implement a uniform set of diagnostic criteria for your practice, this policy implementation will meet next quarter’s “ACTION” requirement!

If you want to take your approach to judiciously treating bronchitis a step further, the Quality Innovation Network National Coordinating Center (QIN-NCC) developed an audit worksheet for tracking antibiotic prescribing for acute bronchitis. This worksheet can help your providers quantify opportunities to improve antibiotic prescribing for this condition.

*TIP* Monitoring your bronchitis patients and identifying whether they receive an antibiotic helps you meet the “TRACKING AND REPORTING” Element!  Not only that, improvement in bronchitis treatment will have a positive impact to your related Merit Based Incentive Payment System (MIPS) score. Learn more about the Quality Payment Program at the Qualis Health Quality Payment Program (QPP) Resource Center.

Check out all the WA DOH “Clinical Practice Guidelines,” NCC Worksheet and lots of other tools through our New Resource Web Page For AMS!

All Hands – Information for All about the Initiative

Keep an eye out for these soon-to-be-released Qualis Health resources:

  • The initial baseline assessment of your AMS practices:  We’ve had a lot of you send us completed assessments, with great descriptions of your ongoing work, new ideas for expanding AMS, and requests for assistance.  However – we have only received responses from 45% of our participating practices. We will be tracking down and following up on these “castaway” reports over the next few weeks. If you know your practice hasn't completed this yet, please "dive in" and complete the baseline assesment now.
  • Our initial Medicare data report will be released in October. The report will include Medicare fee-for-service data for two items
          1) Antibiotic prescriptions by class; and
          2) Antibiotic prescriptions for upper respiratory infection (URI) patients
    We look forward to your input about these reports, as they are an initial stepping-stone toward your ability to track your antibiotic use and performance, moving forward.
  • National Provider Identification verification instructions.  Many of our participating practices have multiple clinic locations and providers.  To improve the accuracy of our “address-specific” information (in future reports), as opposed to the current Tax Identification Number (TIN) reports, we will be providing you a feedback form to identify which of your providers work and prescribe at which locations.
  • Bi-monthly office-hours – Qualis Health staff will be “on deck” to answer any of your AMS Initiative questions, and help you find the resources you need to succeed.  Although you can reach out to our Quality Improvement Consultants any time – these scheduled times will include access to additional staff and experts in the field.  Our tentative dates for our next office hours will be Thursday, November 9th, and Thursday January 11th.

We are excited to be getting this project out “on open water” with you all, and look forward to helping you on your journey to meeting the core elements.