Jigsaw 101: Medication Initiative in Action Antimicrobial Stewardship
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Jigsaw 101: Medication Initiative in Action Antimicrobial Stewardship

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Presented at Optimizing Medications workshop in Vancouver by Victor Leung

Presented at Optimizing Medications workshop in Vancouver by Victor Leung

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Jigsaw 101: Medication Initiative in Action Antimicrobial Stewardship Jigsaw 101: Medication Initiative in Action Antimicrobial Stewardship Presentation Transcript

  • We have an opportunity to delay the post-antibiotic era by improving physicians’ antibiotic prescribing behavior
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  • Systematic and coordinated approach to selecting antimicrobials to achieve optimal outcomes Diagnostic test utilization Data collection + analysis Collaboration with prescribers Academic Detailing Education Stewardship Infrastructure Optimize Antimicrobial Use Formulary restrictions View slide
  • PRIMARY DRIVERS OF INAPPROPRIATE ANTIMICROBIAL USE Indiscriminate laboratory testing Knowledge gaps Inappropriate Antimicrobial Use Inadequate documentation and transitions in care Diagnostic Uncertainty or Fear View slide
  • Fallacies in Antimicrobial Therapy - Broader is better - Failure to respond is failure to cover - When in doubt, change drugs or add - More diseases, more drugs - Sickness requires immediate treatment - Response implies diagnosis - Antibiotics are non-toxic Spiraling empircism, Kim and Gallis, American Journal of Medicine, August 1989, Volume 87
  • CONSEQUENCES OF INAPPROPRIATE ANTIBIOTIC USE Appropriateness of antimicrobials
  • Systematic and coordinated approach to using appropriate antimicrobial agents to achieve optimal outcomes Diagnostic test utilization Data collection + analysis Collaboration with prescribers Academic Detailing Education Stewardship Infrastructure Optimize Antimicrobial Use Formulary restrictions
  • Educational Journal Club Events Reached over 100 Prescribers You are invited to a presentation entitled; Antimicrobial Stewardship for Cardiac Surgery and Cardiology Speakers: Dr. Peter Phillips & Dr. Victor Leung Objectives: 1) Provide a brief overview of Antimicrobial Stewardship at PHC 2) Review of the 2012/2013 pilot of surgical site infection (SSI) surveillance post-CABG and valve surgery 3) Present revisions to peri-operative antimicrobials for cardiac procedures 4) Discuss the management of infections from cardiac arrhythmia device implants at PHC Date and Time: Tuesday November 26, 2013 at 6:30 pm Location: Lupo Restaurant and Vinoteca (869 Hamilton St, Vancouver, BC V6B 2R7 2R7) RSVP: vleung@providencehealth.bc.ca Meal sponsored by
  • Systematic and coordinated approach to using antimicrobial agents to achieve optimal outcomes Diagnostic test utilization Data collection + analysis Collaboration with prescribers Academic Detailing Education Stewardship Infrastructure Optimize Antimicrobial Use Formulary restrictions
  • Academic detailing offers point-of-care education • Microbiologic data • Local resistance patterns • Evidence based guidelines • Potential errors: • Broad spectrum • Dosing • medication interactions • allergies
  • Systematic and coordinated approach to using antimicrobial agents to achieve optimal outcomes Diagnostic test utilization Data collection + analysis Collaboration with prescribers Academic Detailing Education Stewardship Infrastructure Optimize Antimicrobial Use Formulary restrictions
  • Systematic and coordinated approach to using antimicrobial agents to achieve optimal outcomes Diagnostic test utilization Data collection + analysis Collaboration with prescribers Academic Detailing Education Stewardship Infrastructure Optimize Antimicrobial Use Formulary restrictions
  • Investing in ASP saves money Year to Date (YTD) Antibiotic Expenditures $1,600,000 $1,400,000 $1,200,000 $1,000,000 $800,000 $600,000 Antibiotic savings = $411,258 as of fiscal period 9 $400,000 $200,000 $0 1 2 3 4 5 6 7 Periods 8 9 10 11 12 13 Actual Expenditures Budgeted Expenditures
  • Systematic and coordinated approach to using antimicrobial agents to achieve optimal outcomes Diagnostic test utilization Data collection + analysis Collaboration with prescribers Academic Detailing Education Organizational Structure Optimize Antimicrobial Use Formulary restrictions
  • Systematic and coordinated approach to using antimicrobial agents to achieve optimal outcomes Diagnostic test utilization Data collection + analysis Collaboration with prescribers Academic Detailing Education Stewardship Infrastructure Optimize Antimicrobial Use Formulary restrictions
  • Call to action • The next time you prescribe an antimicrobial or assess the need for an antimicrobial, ask yourself: – What am I treating? – How long should I treat? – Is there an alternative, more appropriate antibiotic? bugs&drugs@providencehealth.bc.ca