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The Steward-Ship Laveer

AMS Laveer 690 px


Welcome aboard our AMS Stewardship newsletter

May 2019

Spring is here! – We hope that your AMS program is in full sail this year.  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.

Sailing from a new port – We are now Comagine Health - Qualis Health and HealthInsight have joined forces!

For more than 40 years, Qualis Health and HealthInsight independently engaged in health care quality consulting and provided care management and quality improvement services. We merged to combine our strengths in 2018. Today, we’re Comagine Health .Vist our website to learn more about Comagine Health.

All Hands – Information for All about the Initiative

Office Hours Update – Thank you to those who attended our Office Hours in March – May. During these Office Hours we focused on sustaining and building on your AMS programs.  In March, John Vassall, MD, Senior Medical Executive at Qualis Health discussed readiness for education and we reviewed available education resources for both clinicians and patients. For April office hours, our focus was tracking and reporting.  This session featured a presentation by Natalie Buening, PharmD from Saint Alphonsus Health System, on their work on developing 1) antibiotic utilization reports for their urgent care clinics (2) their AMS newsletter and (3) their outpatient antibiogram. In May, we heard from more practices, large and small, on their successes and barriers in implementing program elements.

Data Reports have been updated – Your secure-file transfer folders have been updated with your seventh Qualis Health report on antibiotic usage among Medicare Beneficiaries, by your Tax Identification Number (TIN). These reports include data for CY2018..


AMS Core Element Completion Certificates 

If you have implemented at least one activity within each of the CDC’s four AMS core elements, we will send you a certificate of completion for each participating setting. Certificate distribution is based on your completion of the core element surveys that we put out quarterly. If you have not updated us, please complete the survey by June 15 to receive your certificate.

AMS Certificate

Our Final Assessment– of your core element implementation is still open– let us know if you have made progress! See information below on instructions for accessing your previously submitted surveys.

  • 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 SPotter@comagine.org for questions on SFTP access for reports.

Through the Porthole – Your Monthly Resource

Viral Prescription Pads

Download this document and bring to a print shop with capacity to provide tear pads. You may want to check with your print shop to confirm that they have this service. Each prescription has 5.5x8.5 inch dimensions. These viral prescription pads can help to facilitate communication between a prescriber and patient, in particular if an antibiotic is expected during an office visit.  These pads have been trialed in several clinic settings with positive feedback.
**TIP** Use of a viral prescription pad is an “action” core element activity. The “Use delayed prescribing or watchful waiting, when appropriate”. Per the CDC definition, “Watchful waiting means providing symptomatic relief with a clear plan for follow-up if infection symptoms worsen or do not improve”.  These prescription pads include symptom relief as well as an area to explicitly describe persistent symptoms of concern:  “please contact your provider if symptoms do not improve in __ days, or worsen at any time”


Clinician Engagement

NEW: This one minute, humorous video might help engage your prescribers in a discussion on the challenges of communication with patients about antibiotic use. 

Still of Antibiotic Video

For more in-depth communication education, view the Rita Mangione-Smith presentation on how to talk to patients about why they do not need an antibiotic at this visit. A brief summary of Mangione-Smith’s evidence-based communication strategy can be found on the DART (Dialogue Around Respiratory IllnessTreatment) website. This communication method study was conducted at Seattle Children’s Hospital, but the findings can be applied to adult communication as well

The World Health Organization has produced a series of courses on antimicrobial stewardship. Topics such as Antibiotic Allergies and Acute Infectious Diarrhea are included in this series.  No CME’s are available.

**TIP** Consider providing AMS education at a medical staff meeting.  Choose educational materials that are relevant to your clinicians and find a champion to promote this.  There are several resources with duration of a few minutes to an hour that could be used to promote awareness of appropriate antibiotic prescribing.

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