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The Steward-Ship Laveer

AMS Laveer 690 px


Welcome aboard our AMS Stewardship newsletter

Welcome to 2018 and our continued AMS activities on the high-seas! We hope we are keeping some wind in your sails with our recent activities.

April 2018

Spring is here – and hopefully you have seen clearer skies and smoother sailing while advancing your AMS programs over the past six-months!  We’re continuing to support your efforts in meeting, maintaining and exceeding at least one activity in each of CDC’s Core Elements of AMS in Outpatient Settings.

All Hands – Information for All about the Initiative

Here are the updates we have for you this month!

Data Reports 2 – Your secure-file transfer folders have been updated with your second Qualis Health report on antibiotic usage among Medicare Beneficiaries, by your Tax Identification Number (TIN). These reports include data from 2016 Q4 through 2017 Q3. For those who submitted your provider’s NPI numbers by location to us, you will see those reports as well.

Time frame: October, 2016 to September, 2017
Changes from the first report:
- Specific antibiotic volume chart has been removed
- Current Figure 3 “Overall Medicare Claims” now includes only Part D Medicare Beneficiaries

  • If you sent NPI by location information to us, you will receive location-specific reports in your SFTP folder
  • Please contact us with any questions about the report AMS

Activities Assessment 2 – It will be time for us to update CMS on your collective progress in late April, so we’re giving you another opportunity to let us know how your AMS processes are moving ahead with this “second” assessment (but third survey after the initial “baseline” from August 2017). To see some aggregate results from assessment 1, keep reading! Also, for those who completed assessment 1, a PDF of your responses has been uploaded to your secure-file transfer folder (file name is [Your TIN]_[State]_Assessment1.PDF). https://www.surveymonkey.com/r/6PZS3KM

MIPS Documents from Office Hours – Thank you to those who attended the 02/08/18 and 03/08/18 Office Hours. In February we provided some materials about how your providers can earn MIPS credit through participation in this AMS initiative. The slide-presentation is available here, and you’re about to hear more about one of the resources that were discussed.

New Office Hours: Thursday, April 12, 2018 at 12:30-1:30 MT, 11:30-12:30 PT. Please Register Here. We will launch the April call with an update on our website offerings and follow-up report discussion. Other topics welcome!

Through the Porthole – Your Monthly Resource

TRACKING AND REPORTING remains one of the more challenging components to developing an AMS program – but it is essential to measure what you want to improve. Qualis Health is launching two new tools that can assist with tracking your AMS measures. We will be developing additional tools to include more diagnoses and measures relevant to improving antibiotic use.

1) AMS Audit and Tracking Tool: 2018 QPP MIPS Measures

Download Audit Tool

During our recent office hours, we introduced a “lower-tech” option to meet some “TRACKING AND REPORTING” Core Element activities. Just enter your monthly data and a run chart will auto-populate. This tool is intended to assist you in tracking the MIPs quality measures that align with your AMS program, with untitled graphs available for tracking additional measures.

We’ve built in the 5th decile performance benchmarks for the 2018 MIPs AMS-related measures. This tool will allow you to compare your performance to the benchmark, estimate points for each quality measure, and track progress towards organization-specific goals over time.

For more information on MIPs and the Quality Payment program visit our MIPS and QPP web page.

For details on CMS Quality Measures in MIPs, visit the CMS QPP Resource web page.

**TIP** Tracking one or more of these MIPs measures will work double time: You will earn points toward your Quality Payment Program score AND track valuable data to drive your antimicrobial stewardship program. Any of these measures would satisfy the Tracking and Reporting core element “Track and report antibiotic prescribing for one or more high priority conditions”.

2) AMS Audit and Tracking Tool: Avoid Prescribing for Upper Respiratory Infection

View Tool Example
Download Audit Tool

Acute respiratory conditions are the most common diagnoses associated with outpatient antibiotic prescribing. Many of these infections are viral and require no antibiotics. Use this chart audit tool to review how your prescribing practices compare to current treatment recommendations. After entering your data, a run chart will populate into a document that can be used to report out your data to your leadership and AMS committees.

**TIP** It takes time, but reviewing charts is a valuable way to collect data on antibiotic prescribing by provider and diagnosis. This type of deep dive that includes patient history will provide more data to inform activities for your antimicrobial stewardship program. Tracking inappropriate antibiotic prescribing for upper respiratory infections satisfies the Tracking and Reporting core element “Track and report antibiotic prescribing for one or more high priority conditions”.

Both of these tools to help your own TRACKING AND REPORTING, can be found on our updated Selected Resources web page, under “Data Tracking Tools”.

Flotsom and Jetsam - Bonus Resources!

Here are some additional resources that we want to make sure don’t “drift” by you…

These resources can be found on our EDUCATION AND EXPERTISE Section of our Resources Page.

Educational Offerings – We’ve heard that many of you are interested in more provider and nurse education offerings related to AMS, which include continuing medical and nursing education credits. Here are two recorded educational sources here that can be watched at your convenience:

Elsevier’s Office of Continuing Medical Education:
Addressing the Urgent Threat: Strategies for Combating Hard-To-Treat Bacterial Infections – George Sakoulas, MD, University of California
Participants will have the “opportunity to review the clinical utility of new and investigational antimicrobials while also focusing on strategies to promote careful, appropriate antibiotic utilization. Interactive patient case scenarios will allow clinicians to apply acquired knowledge of antibiotic use to real-world examples of treating patients with [antibiotic-resistant Gram-positive and –negative] infections.”

Target Audience: Infectious disease specialists, primary care clinicians, and microbiologists. No prerequisites required.
View the Recording. Est. time to complete: 120 minutes.

Stanford University, School of Medicine:
To Prescribe or not to Prescribe? Antibiotics and Outpatient Infections – Stan Deresinski, MD, FIDSA & Marisa Holubar, MD, MS, Stanford University School of Medicine
A practical approach to the management of common outpatient infections through the use of didactic videos, patient role plays and interactive case based video. National guidelines will be reviewed with emphasis on the most appropriate empiric antibiotic choice and duration of therapy. Video role plays will demonstrate communication skills that can be used with patients regarding appropriate antibiotic usage.

Target Audience: Physicians in family practice, primary care, internal medicine, obstetrics and gynecology, emergency medicine, pharmacists, as well as nurse practitioners, physician assistants, and allied health professionals.
View the Recording. Est. time to complete: 105 minutes.

*Note – Stanford Online CME’s training videos may encounter errors when accessed using Internet Explorer web browser. They recommend accessing via Google Chrome or Mozilla FireFox web browsers.

**TIP** These “archived” resources are great tools for one-off training prompts to your physicians, or for incorporating trainings like these into your new prescriber orientation materials. Ongoing distribution of AMS resources on communicating about AMS to your clinicians meets the “Provide communication skills training for clinicians” activity of the ACTION Core Element. Hardwiring completion of these or similar AMS focused trainings into your facility’s professional development record-keeping (for CMEs/CNEs, etc.) can be used to meet the “[All clinicians] participate in continuing medical education and quality improvement activities to track and improve antibiotic prescribing” activity of the TRACKING AND REPORTING Core Element. Finally, distributing these continuing education AMS resources to your providers meets one of the facility-level antibiotic education activities in the EDUCATION AND EXPERTISE Core Element.

From the Crow’s Nest – Overview of Progress for the Qualis Health AMS in Outpatient Settings Initiative

With the first quarterly follow-up assessment closed, we can present to you the collective progress in both states on implementing CDC’s Core Elements and activities, since the “baseline” from August 2017 (hyperlinks below). Although we know you are all “rowing” hard to improve your AMS Programs, we haven’t heard from many of you. Washington has received only 25% of the responses compared to our baseline assessment (which was still missing information from about 25% of our total practices)! So, to not be “ships passing in the night”, we will be reaching out to some of you to ensure we receive some indication of where you are in your AMS implementation efforts. This way we can make sure we identify anyone “hauling wind”, or worse, still “anchored” at the start!

View Idaho Progress Summary
View Washington State Progress Summary

As a reminder, past issues of the Laveer can now be found through the “Initiative Information” section at the bottom of our Resources Page.

As always, your stalwart stewardship-mates Martha and Jason are here to help you on your AMS journey. Don’t hesitate to give us an “ahoy”.