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Antimicrobial Stewardship in Outpatient Settings


Martha Jaworski, MS, RN, CIC
Fax (208) 343-4705
Phone (208) 383-5944

Washington State
Paula Parsons

Fax (206) 366-3370
Phone (206) 288-2553

For AMS tools and resources, visit our Selected Resources page!

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Qualis Health is working to help improve antimicrobial stewardship in the Northwest by working with Idaho and Washington State outpatient care settings to develop and improve their antimicrobial stewardship (AMS) programs.

Why Antimicrobial Stewardship is Important:

AMS Bacteria

Use of antibiotics selects for multidrug resistant bacteria at a population level.

AMS Heart

Antibiotic use is the highest risk factor for development of Clostridium difficile infection.

AMS Stone

23,000 people die each year in the U.S. due to antibiotic resistant bacterial infections.

AMS Pill Bottle

Fewer new antibiotics are being developed each year to treat resistant infections.


Use, misuse and overuse of our existing antibiotics increases the likelihood of developing drug resistant infections.  With fewer new antibiotic resources, and decreased effectiveness of our existing options to treat multidrug resistant organisms, it is imperative that we prescribe antibiotics appropriately now!  Appropriate use today will help to preserve antibiotic effectiveness in the future.

Your partners in Idaho and Washington State are working together in the fight against antibiotic misuse and drug-resistant infections, in part, through building and improving antimicrobial stewardship programs. Improving outpatient antimicrobial stewardship practices are essential as we, work as a region, towards protecting our valuable antibiotic resources.  Efforts are underway across the healthcare continuum and communities, to promote stewardship in all areas antibiotics are used, including human and animal health settings.


AMS Threat1

This report, Antibiotic Resistance Threats in the United States, 2013 gives a first-ever snapshot of the burden and threats posed by the antibiotic-resistant germs having the most impact on human health.


Qualis Health's Antimicrobial Stewardship in Outpatient Settings Program

Qualis Health is working with Idaho and Washington State outpatient care settings to improve antimicrobial stewardship programs by helping practices meet and exceed CDC’s Core Elements of Outpatient Antibiotic Stewardship Guidelines. We are working with primary care, urgent care, emergency departments, pharmacies, and any other outpatient setting.

The Core Elements are:

COMMITMENT Leadership actively supports optimizing antibiotic prescribing and patient safety related to antibiotics.

Each of our participants are offered free posters demonstrating their leadership's commitment to antimicrobial stewardship.

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ACTION - Implement policies to improve antibiotic prescribing and assess the impact of these policies.

TRACKING & REPORTING - Implement a method to track your antibiotic use.  Be aware of complications and resistance trends among your patients.  Offer feedback to prescribers.

EDUCATION & EXPERTISE - Educate prescribers on evidence-based guidelines to optimize antibiotic prescribing.  Communicate appropriate antibiotic use to your patients.


These recommendations align with foundational stewardship program elements for hospitals and nursing homes, ensuring the same best practices are in place across the healthcare continuum. However, as 80% of all antibiotics are prescribed outside of the hospital setting, we need to expand these critical efforts beyond inpatient care to post-acute and ambulatory facilities. 

Through this initiative we will also be providing access to tools for providers and patients to allow informed decision-making when considering antibiotic prescriptions for upper respiratory infections, and other commonly misdiagnosed conditions, through distributing consumer education, encouraging patient activation, and sharing clinical guidelines. Keep an eye out for new materials on our Selected Resources page.

For those practices and facilities that are already achieving CDC’s Core Elements, we want to hear from you!  Your leadership and sharing of best practices can help other facilities and providers in Idaho and Washington strengthen stewardship efforts to improve the quality of care and protect patients across the Pacific Northwest.