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The Steward-Ship Laveer

AMS Laveer 690 px


Welcome aboard our AMS Stewardship newsletter

February 2019

Happy New Year! – wishing you and your AMS program successful sailing in 2019!  We continue to support your efforts in meeting, maintaining and exceeding at least one activity in each of the CDC’s Core Elements of AMS in Outpatient Settings. We look forward to working with you on reaching your goals.

All Hands – Information for All about the Initiative

Viral Prescription Pads:  Interested in trialing some viral prescription pads? Some clinics have created their own prescription pads and have found that providing this information to patients can be a successful action to improve patient and prescriber satisfaction.  Qualis Health has developed a viral prescription pad and has printed a limited quantity. Contact us if you are interested in trying these and we will send you one to test in your clinic. Click on the image below to see full size of the pad.



Office Hours Update

Office Hours Update – Thank you to those who attended our Office Hours in November- February.  During these Office Hours we provided demonstrations of our UTI and URI audit tools and are working with interested organizations on using EHR data to populate the graphs in these tools.  In January, John Vassall, Senior Medical Executive at Qualis Health discussed leadership support and how to engage physicians; February office hours featured Marisa D’Angeli, MD, MPH, who presented the WA DOH practice guidelines for URI.  In March, we will discuss outpatient AMS data, what to track and how to present data to your providers, AMS committee and others.

Here is the schedule for this spring’s Office Hours:

3-21-19 – March 21:  Tracking and Reporting
4-11-19 – April 11:  Education (Clinician and Patient)
5-09-19 – May 9:  Report out on successes!

Note that Office hours are NOT formal webinars.  There will be a brief educational session and time for discussion and questions.  

Data Reports have been updated – Your secure-file transfer folders have been updated with your sixth Qualis Health report on antibiotic usage among Medicare Beneficiaries, by your Tax Identification Number (TIN).  These reports include data from 2017 Q4 through 2018 Q3.


AMS Activities Assessment– We will update CMS on your collective progress toward implementing the four core elements with this final assessment of your core element implementation – let us know if you have made progress! 

  • If you completed previous assessments, PDFs of your responses have been uploaded to your secure-file transfer folder (file name is [Your TIN]_ [State]_Assessment_.PDF).
  • Please contact Suzie Potter at susanp@qualishealth.org for questions on SFTP access for reports.

Through the Porthole – Your Monthly Resource

Here is a new tool to help you track treatment of UTI patients!

  • *NEW* UTI Audit Tool:  This is an example of the tool populated with sample data. Please go to the website for the blank template to enter your own data! This toll will let you review some patient charts and determine how well prescribers are following treatment recommendations for uncomplicated UTI. This tool will help you identify variation in prescribing among your providers, frequency of treatment of asymptomatic UTI and measure antibiotic appropriateness when culture results become available.

**TIP** Use this tool to dive into your own data on urinary tract infection prescribing.  Collecting and reporting this data is a great way to engage prescribers by viewing overall trends as well as variation among peers.  According to the CDC, UTI is a common diagnosis resulting in antibiotic prescriptions in outpatient settings.    Due to the volume of prescriptions, limiting the use of broad spectrum antibiotics for this diagnosis can have an impact on reducing resistance. 


Clinician Education

Can you improve antibiotic prescribing without decreasing your patient satisfaction scores?  On August 29, 2018 the National Coordinating Center (NCC) hosted the presentation "Reducing Inappropriate Antibiotic Prescribing in Outpatient Settings Using Behavioral Interventions".  This presentation focuses on behavioral interventions for providers to reduce unnecessary antibiotic prescribing, while maintaining patient satisfaction with care.  The following nationally recognized speakers provided excellent presentations:

  • Katherine Fleming-Dutra, MD, Center for Disease Control and Prevention provides an overview and data update
  • Daniella Meeker, PhD, Keck School of Medicine, University of Southern California discusses her publications on “nudging” providers through public commitment and providing specific feedback.
  • Larissa May, MSPH, MSHS, University of California-Davis describes specifics of antimicrobial stewardship in emergency departments and urgent care settings and reviews the research that resulted in the MITIGATE toolkit.

**TIP** Use this presentation at staff meetings to provide information on antimicrobial stewardship interventions that really work.   This can be a component of your staff educational program and can help to satisfy the “Education and Expertise” core element of “Clinician Antibiotic Stewardship Education”.

AMS Education – Does your emergency department have an AMS program?  Many antibiotics are started in the emergency department - how does this impact your inpatient and outpatient antibiotic use?  Does your system include appropriate patient follow up? View the 30 minute recording of “Achieving Both Hospital and Outpatient Antibiotic Core Elements in Emergency Service” by the Lake Superior QIN/QIO, which reviews the relevant core elements and TJC requirements that impact this setting. This is particularly relevant to any emergency department representatives on hospital AMS committees.

**TIP** Understanding the AMS challenges of different practice settings is critical to a seamless AMS program for a hospital.

Patient Education

Check out the CDC site for patient education materials on certain infectious conditions.  There is some new formatting.  On-line descriptions are also available in Spanish.  In addition to the on-line material, there are 2-page flyers providing education on  Acute Bronchitis and Preventing and Treating Ear Infections.

**TIP** Educating patients on general topics related to antibiotic resistance and infection prevention will help them to understand your antimicrobial stewardship efforts.   Distributing or directing patients to this information antibiotic resistance and reducing infections satisfies the “Education and Expertise” core element of “Educate about the potential harms of antibiotic treatment”.


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