A new effort led by the Massachusetts-based Institute for Healthcare Improvement will aim to decrease the overuse and misuse of antibiotics in hospitals, a growing problem across U.S. healthcare facilities.
Eight hospitals in eight states will pilot the program, which was designed in collaboration with the federal Centers for Disease Control and Prevention. The pilot program, announced on Nov. 15, focuses on a new jointly developed initiative, the CDC/IHI Driver Diagram and Change Package for Antibiotic Stewardship.
The testing sites include a range of different sized hospitals, including Community Hospital in Tallassee, Ala.; Centerpoint Medical Center in Independence, Mo.; Rogue Valley Medical Center in Medford, Ore.; St. Francis Medical Center in Peoria, Ill.; Seton Medical Center in Austin, Texas; Reading Hospital and Medical Center in West Reading, Pa.; Ronald Reagan UCLA Medical Center in Los Angeles; and WellStar Cobb Hospital in Austell, Ga.
According to IHI, one of the challenges to improving antibiotic use in hospitals is that there is a lack of blueprints or plans that have been implemented that instruct hospitals on how to cut down on the misuse of antibiotics.
But the IHI and CDC’s Driver Diagram and Change Package use an established method for improving care in hospitals. A driver diagram is a tool to help organize theories and ideas about the ways an organization can work to improve outcomes. On the other hand, a change package provides changes and ideas for improvement for each of the drivers associated with the overall aim or outcome.
Jointly developed by CDC and IHI with guidance and input from a variety of experts, the Driver Diagram and Change Package lays out a number of practical steps that hospitals can follow to help reduce the rate of overuse and misuse of antibiotics. Ultimately, the diagram and package will seek to carry out any proposed changes needed to improve the use of antibiotics in the healthcare system, especially at the front line.
While antibiotics are often the most powerful medical tool in combating life-threatening bacterial diseases, their effectiveness is compromised when they are used inappropriately. Overuse and misuse contribute both to antibiotic resistance, a growing problem in the United States and elsewhere, and to a decrease in the supply of these vital resources. An estimated 50 percent or more of antibiotic use in U.S. hospitals is inappropriate.
Dr. Edward Septimus, medical director of infection prevention and epidemiology for the Hospital Corporation of America, will serve as the faculty lead for the testing project.
“We know improvements in antibiotic use can be made, and this project will help us better understand how to make them in a variety of different hospital settings,” Septimus said in an IHI press release.
Dr. Scott Flanders, professor of medicine at the University of Michigan and past president of the Society of Hospital Medicine, the largest organization representing hospitalists, will also serve as a faculty member to oversee the pilot program.
“Increasingly, hospitalists are on the front line of care in U.S. hospitals,” Flanders said. “They are well-positioned to contribute to this pilot project and have a longstanding commitment to improving health care quality.”
The Institute for Healthcare Improvement, based in Cambridge, Mass., is an independent nonprofit organization that works with healthcare providers and other health organizations leaders to improve the safety and effectiveness of healthcare.
Arjun Srinivasan, medical director of the CDC’s Get Smart for Healthcare program, which aims to improve antibiotic use in hospitals, said in a statement that the goal of pilot program is to help develop a practical action plan that all hospitals eventually will be able to use and implement to improve antibiotic use.
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