Healthcare stakeholders have long recognized that quality improvement is a shared mission across the healthcare continuum. Greater collaboration around best practices and unified efforts to raise the bar on performance are foundational to success within the fee-for-value climate.
And while every stakeholder plays a critical role, the industry at large increasingly recognizes the pivotal role pharmacy plays in circumventing the potential for adverse patient events. Always sharply-focused on ensuring appropriate medication use and patient safety, pharmacists must now turn their attention to antimicrobial stewardship and healthcare-associated infections (HAIs) as national initiatives continue to raise the bar on performance in these areas. In fact, the American Society of Health-System Pharmacists points to pharmacy resources as a vital link to enhancing patient health through greater understanding of antimicrobial infections and diseases.
As such, healthcare organizations must strategically use pharmacy resources in a top-of-license manner—defined by leveraging staff expertise at its highest level. Hospitals and health systems, for instance, must consider how manual workflows limit critical pharmacy resources from optimizing response to high-level quality initiatives. Are they spending too much of their time shuffling paper and manually tracking data? Or, is clinical response reactive as opposed to proactive?
It’s a challenge and opportunity for today’s healthcare organizations as they consider how best to allocate investments amid limited resources. Amid higher performance expectations, many are finding it necessary to equip pharmacists with the tools needed to optimize workflows, support greater collaboration and ultimately, help avoid financial and reputational consequences associated with HAIs and antimicrobial use.
The Intersection of HAIs and Antimicrobial Stewardship
HAIs remain a focal point of national regulatory movements as these preventable conditions increase mortality rates, prolong hospital stays and consume notable healthcare resources. In 2008, the Centers for Medicare and Medicaid Services stopped reimbursing for a number of HAIs and now penalize hospitals with excessive rates of:
- Central-line associated bloodstream infection (CLABSI)
- Catheter-associated urinary tract infection (CAUTI)
- Surgical-site infection (SSI): colon surgery and abdominal hysterectomy
- Hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia
- Hospital-onset clostridium difficile (C.diff)
Estimates from the Centers for Disease Control and Prevention suggest that as much as 50 percent of antibiotics prescribed today are unnecessary or inappropriate. This rampant misuse significantly contributes to growth of multi-drug resistant organisms (MDROs) such as MRSA as well as the incidence of CLABSI and CAUTI. It is here that the intersection of antimicrobial stewardship and HAIs is clearly evident.
Clinical leaders increasingly find that a high-performing antimicrobial stewardship program (ASP) can generate notable return on investment. When pharmacy resources are leveraged in a top-of-license manner to improve the use of antimicrobial agents by encouraging the appropriate choice of drug, regimen, dosing, duration and route of therapy, hospitals realize significant improvement in patient outcomes and costs.
Empowering Pharmacy for Optimal Response
There are two critical factors that hinder healthcare organizations in their ability to fully leverage pharmacy resources: 1) manual, burdensome workflows and 2) access to the right data. Pharmacists must have the most up-to-date, current patient data to support proactive intervention, and they must have time to devote to high-level initiatives.
Advanced clinical surveillance decision support solutions like Sentri7® provide the critical IT support needed to streamline workflows associated with optimizing medication management, infection prevention and antimicrobial stewardship. By providing clinical teams with timely, actionable, evidence-based guidance to circumvent potential adverse events, the solution promotes early intervention and appropriate treatment.
Sentri7 aggregates patient data in real-time, automating the tracking, identification and reporting of potential antimicrobial issues. Intelligently-filtered information built on customized rules prompts clinicians to respond to potential issues. Also, real-time notification of orders for restricted antimicrobials, drug-bug mismatches, comparisons of antimicrobial regimens, renal function surveillance, patient allergy or drug-drug interaction risks and possible hospital-acquired infections ensure rapid, effective response.
Sentri7 is the 2013, 2015/2016 and 2017 KLAS category leader for Clinical Decision Support – Surveillance, with top honors for General Satisfaction, Functionality and Sales/Contracting. Users report:
- 15-25% reduction in antimicrobial expenditures and savings of $750,000 per year on average
- 15% reduction in HAIs, 56% reduction in C. Diff and 49% reduction in CAUTI
- 35% decrease in antibiotic costs per patient-day
- 54-750% increase in the number of clinical interventions to improve appropriate use of antimicrobials