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The Steward-Ship Laveer

AMS Laveer 690 px

January, 2018


Welcome Aboard our AMS 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.

All Hands – Information for All about the Initiative

Messages in bottles – this month we have four things we would like to bring to your attention:

  • If you haven’t already, update your quarterly progress and maintenance of AMS improvement activities here (estimated time 5-10 minutes): https://www.surveymonkey.com/r/9D2G9QM
  • Your first quarterly AMS report has been released (see below).
  • Update us on which providers work at which locations (via the secure file transfer instructions emailed 12/22/2018, sent by QualisHealthAMS@qualishealth.org, to improve your next quarterly report.

If you have not received these email communications – please contact Martha or Jason.

  • Office hours: February 8, 2018 at 12:30-1:30 MT, 11:30-12:30 PT. Please register now. We will launch the February call with an update on quality payment program quality measures associated with antibiotic stewardship. A summary of the 1/11 office hours will be sent out shortly.

We are STILL accepting requests for free (for a limited time) printed 11” x 17” exam-room posters, customized for individual providers to attest to their commitment to AMS. Most practices are meeting multiple “COMMITMENT” Core Elements, so if you need more patient-facing communication, please fill out THE FORM for your state and scan or fax the completed request back to Martha in Boise or Jason in Seattle by the end of February .

Idaho Form

Washington State Form

Through the Porthole – Your Monthly Resource

This month we will direct you to resources for the “TRACKING AND REPORTING” Core Element – which remains one of the more challenging components of developing and maintaining an AMS Program.

1) The Qualis Health Antimicrobial Stewardship Data Report. On December 22nd, we distributed two emails with usernames and passwords to each of our contacts in this project. Logging in to the secure website will give you access to our first quarterly AMS report on your TIN’s antibiotic use data among Medicare beneficiaries. If you haven’t done any AMS data tracking or report-backs to your providers, this may be the first “bulkhead” in initiating conversations and preparing future goals.

AMS Report Thumbnail

If you haven’t received these two emails (check your spam filters and junk mailbox for Dec. 22), then let us know and we will resend you the information on how to access to your secure site and see your data.

*TIP* If you haven’t looked at your report yet, please do!  Setting up meetings with your providers to discuss this, and other AMS data helps meet the “Track and report antibiotic prescribing for one or more high priority conditions” activity.  If you don’t have enough Medicare patient volume to see many upper respiratory infections, you could always focus on reducing use of certain antibiotics or classes – like bringing down those “high-seas” (Cephalosporins, Ciprofloxacin, and Clindamycin).

If our report isn’t quite the “sextant” you need for keeping your antibiotic improvement goals in “sight”, we have two additional resources that may help.

2) Our sister Quality Improvement Organization, Telligen (Colorado, Illinois and Iowa), developed an Outpatient Antibiotic Stewardship Clinical Quality Measure Specification Guidebook. This is similar to the Upper Respiratory Infection specification used in our report – developed by the Washington State Choosing Wisely Task Force.  This specification set includes how to track (using billing data) antibiotic use and therapy avoidance among other high priority conditions, including:

  • Adult Acute Bronchitis
  • Adult Sinusitis (overuse versus appropriate use)
  • Acute Otitis Externa (topical and non-topical therapy)

If you find these specifications useful for your practice, let us know. We will be looking to expand the conditions we address in our own reports in the future, and your feedback on these measures can help!

*TIP* Routinely monitoring and reporting prescribing rates back to prescribers on any of these conditions also satisfies activities within the TRACK AND REPORT Core Element.

*BONUS – these quality measures are also included in the Quality Payment Program (QPP) for eligible practitioners to receive credit for monitoring improvement. Check it out!

3) “JumpStart Stewardship” Workbook.  Whether you’re using your own electronic health record system, our Qualis Health reports, or pen-and-paper records of how many patient encounters receive antibiotics – all these approaches to TRACKING AND REPORTING need tools to plan out your AMS goals. The Washington State Department of Health, Healthcare Associated Infections Program, and other partners in AMS, developed a workbook to assist outpatient settings in improving their AMS programs. Among the many resources within this “JumpStart Stewardship” Workbook for Ambulatory Settings (which we will discuss further in future newsletters), a weekly timeline template is provided to help maintain the momentum from your AMS meetings, and track progress toward your goals.

JumpStart Guide Thumbnail

*TIP* Usage of this workbook’s AMS “Implementation Timeline” meets either “Participate in quality improvement activities to track and improve antibiotic prescribing” and “Assess and share performance on quality measures and established reduction goals addressing appropriate antibiotic prescribing” activity.

All these resources, and more, can be found on our AMS Selected Resources webpage.

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

Make sure you complete your quarterly assessment using the hyperlink in the initial bulletted list in "All Hands" at the start of the message, so we can update everyone on the collective improvements in AMS activities.

Since we have practices in both Idaho and Washington State, we thought we’d share the distribution of potential inappropriate antibiotic use for upper-respiratory infection (URI) diagnosed Medicare patients, in both states (per a claims-based technical specification criteria). Both plots describe April 2016 through March 2017 Medicare Part D claims data. The details on this information, and where your TIN shows up, is available in your respective reports in your SFTP folders.

AMS Plot Graphs Thumbnail

View the report.