Louisiana success stories

LA Success Stories
Quality improvement endeavors can often feel overwhelming, but chances are, you can learn from the experiences that another physician, hospital or nursing home has had in a similar situation. Coupled with support from Quality Insights Quality Innovation Network, learning what has worked for others — and what didn't — is a valuable strategic planning component. 

We encourage you to read the success stories, contact us for more information, and also let us know if you have a Quality Insights' success story to share.

University Medical Center Successfully Expands Antibiotic Stewardship Program to New Settings

3/18/2019
University Medical Center (UMC) in New Orleans, Louisiana recognizes the importance of internal teamwork and partnership in its efforts to combat antibiotic resistance and improper antibiotic prescribing. UMC had successfully implemented an inpatient antibiotic stewardship program, and in August 2017, they took that program a step farther by expanding it to include outpatient settings as well.
 
“We know that continuity of care across the different levels of healthcare is becoming more important as the threat of antimicrobial resistance grows,” said Jennifer Lambert, PharmD, MPA, Clinical Pharmacist at UMC.  We wanted to establish a program that incorporates engaging all our partners in the ED, clinics, and outpatient pharmacy, and find ways to make it sustainable so that we may grow and enhance our practices.”

UMC Team
Pictured: UMC’s Inpatient and Outpatient ASP Team
 

The UMC team’s first step toward creating an outpatient antibiotic stewardship program (ASP) was to bring the different stakeholders to the table and integrate the new mission into the already existing UMC ASP policy. This got everyone – literally – on the same page right from the start.

After that, it was all about education. UMC’s ASP team provided education on antibiotic stewardship and antibiotic resistance to clinicians in the outpatient settings. That education consisted of participating in Quality Insights’ webinars, providing monthly presentations to the emergency department staff and making modifications to the after-visit summaries in UMC’s computer system to include language about good antibiotic stewardship practices. Integrating outpatient guidelines and protocols on the institution’s UMC companion app (used on computers, tablets and phones) was another very important step. 

UMC’s ASP team also recognized the importance of patient education. The team engaged UMC’s outpatient Walgreens pharmacy to offer several patient resources about antibiotic resistance in the prescription pick-up waiting areas.

UMC Team

Pictured: Contest winners during ASP staff education
Along with the spread of system-wide change comes barriers to change, and UMC was not immune to those. Getting partners engaged and collecting reliable data to track success were two main challenges the team faced. To combat these issues, the team conducted one-on-one meetings with different stakeholders to help increase productivity and engagement. The team also had to work very closely with their data analyst to obtain timely and accurate reports. They found it helpful to include reminders to run the report on certain dates and to also automate the report when possible. This continues to be a work in progress.

UMC’s outpatient antibiotic stewardship program is definitely moving in the right direction. The team plans to continue to track and trend the data in the outpatient setting and use this to identify new areas of focus for education. They are also hoping to have more staff dedicated to assisting and monitoring our clinical staff in the clinics and emergency department with antibiotic stewardship.

“It was certainly a pleasure working with the staff at Quality Insights during this project,” said Jennifer. “It definitely takes a village to combat antimicrobial resistance and improve outpatient antibiotic prescribing practices.”