HHS, AHRQ, HAI, and CUSP

1. What is the goal of this program?

The goal of this program is implement a bundle of technical and adaptive interventions designed to improve the use of antibiotics at acute care, long-term care, and ambulatory care facilities across the United States.

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2. How long is this collaborative?

Enrollment into the AHRQ Safety Program for Improving Antibiotic Use is a one-year commitment.

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3. What are the benefits of participating?

There are a number of benefits associated with participating in this program. Some of these include:
  • A reduction in patient harm related to unnecessary antibiotic use
  • A reduction in antibiotic usage
  • An improved safety culture
  • Enhanced teamwork and communication
  • Improved patient, family, provider, and staff satisfaction
  • Compliance with regulatory bodies for standards related to antibiotic stewardship (e.g., The Joint Commission in the acute care setting, The Centers for Medicare and Medicaid Services in the long-term care setting, etc.)
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4. When will enrollment into the AHRQ Safety Program for Improving Antibiotic Use occur?

If you are interested in participating in any of the cohorts (acute care, long-term care, or ambulatory care), please email us at antibioticsafety@norc.org at any time – even before the official recruitment period.

July 2017: We will start recruiting Acute Care Settings
July 2018: We will start recruiting Long-Term Care Settings
July 2019: We will start recruiting Ambulatory Care  and Urgent Care Settings

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5. Who is eligible to participate?

All United States hospitals, long-term care facilities, and ambulatory/urgent care clinics are invited to participate. Although entire hospitals are encouraged to participate, individual units or clinical services can still participate.

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6. Who is the National Project Team?

Click here to learn more about the team.

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7. Our facility does not have an Antibiotic Stewardship Program (ASP). Can we still participate?

Absolutely! Training will be available for institutions both with and without ASPs. If an ASP is present, we will work with both the ASP and frontline staff so they understand how to identify defects in their healthcare setting related to antibiotic use and how to implement both technical and adaptive solutions to improve patient safety surrounding antibiotic prescribing. If an ASP is not present, we will work with clinicians who are interested in learning the principles of antibiotic stewardship to train them to become antibiotic stewards.

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8. What material do I need to complete before the kickoff of my cohort?

A letter of commitment, a data use agreement (no protected health information will be requested), and an Institutional Review Board (IRB) approval form, if needed by your facility. We can provide a draft version of a completed IRB to facilitate with this process.

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9. How will antibiotic usage data be shared?

Facility specific antibiotic use data will only be available to that specific facility. However, any particular facility will be able to compare their antibiotic usage with other facilities. The data for other facilities will be de-identified so only team members from your facility will know the identity of your institution’s antibiotic usage data.

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10. Are in-person meetings required?

There will be no face-to-face meetings for the facility teams. All information will be shared via webinars discussed over conference calls, eLearning modules, and email.

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11. What data will be tracked?

Depending on the facility type, the following outcome measures will be collected:
Setting Relevant Measures
Acute Care
  • Days of antibiotic therapy per 1,000 days present (monthly)
  • Clostridium difficile laboratory event episodes per 10,000 patient-days by unit (quarterly)
  • CUSP teams should review 10 patients actively receiving antibiotics with the antibiotic stewardship team to identify areas for improvement (monthly)
Long-Term Care
  • Antibiotic starts per 1,000 resident-days (and, if possible, days of antibiotic therapy per 1,000 resident-days (monthly)
  • Number of urine cultures obtained per 1,000 resident-days (monthly)
  • Clostridium difficile laboratory event episodes per 10,000 resident-days (quarterly)
Ambulatory Care
  • Antibiotic therapy prescriptions per 100 patient visits
  • Numbers of prescriptions associated with individual acute respiratory infection ICD-10 codes
All
  • Structural Assessment (one-page questionnaire about existing infrastructure)
  • Patient Safety Culture Change Surveys
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12. What is your definition of "unit" for the Safety Program?

For this project, a unit is an area with defined and consistent staff who care for patients. In the acute care setting it can be a unit or clinical service. In the long-term care setting it may be an entire nursing home. In the ambulatory care setting it may be a practice or urgent care center.

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13. How does this program align with the Centers for Medicare & Medicaid Services (CMS) Hospital Improvement Innovation Network (HIIN) program?

This AHRQ Safety Program for Improving Antibiotic Use is complementary to the Hospital Improvement Innovation Network (HIIN) program. One of the HIIN core topics is reduction in Clostridium difficile bacterial infections, and includes antibiotic stewardship. The AHRQ program provides a comprehensive program to assist hospitals in reaching their goals of improved prescribing and reduction of all antibiotic-related harms, including Clostridium difficile infections. Hospitals can elect to participate in both the HIIN and AHRQ programs.

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14. How does this program align with the Centers for Medicare & Medicaid Services’ (CMS) antibiotic stewardship goals for long term-care facilities?

Beginning November 28, 2017, CMS will require antibiotic stewardship in long-term care facilities for reimbursement of healthcare costs. Participation in the AHRQ Patient Safety Program for Improving Antibiotic Use will help you to meet these requirements, which include the use of antibiotic prescribing protocols and systems for monitoring antibiotic use.

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15. How does this program align with the Merit-based Incentive Payment System (MIPS) reporting goals for ambulatory care facilities?

Participation in the AHRQ Patient Safety Program for Improving Antibiotic Use will help you to fulfill your quality reporting goals for the Merit-based Incentive Payment System (MIPS), one of two tracks under the Medicare Access and CHIP Reauthorization Act (MACRA). The Program assists you in meeting MIPS quality measures related to several different conditions such as adult sinusitis, acute bronchitis, chronic sinusitis, and acute otitis externa.

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