Thursday, July 03, 2014

Hospitalist driven process to improve antibiotic utilization

These include a periodic antibiotic timeout (scheduled conversations with a clinical pharmacist) and certain documentation requirements concerning the antibiotic order in the medical record. The result was improvement in processes of care:


During a 2 week pilot period, 46% (251/545) of sampled patients were on antibiotics. Documentation of all antibiotic components (indication, day of treatment, and expected duration) significantly improved from baseline after the intervention; 4% (2/48) vs. 51% (36/70) for progress notes, 10% (2/20) vs. 84% (62/74) for discharge summaries, and 18% (8/44) vs. 50% (68/135)for service sign-outs (P less than 0.001 for all comparisons). In total, 582 antibiotic time-outs were evaluated, a quarter of which resulted in changes to antibiotic regimens, and of all changes made, 27% resulted in discontinuation of antibiotics during the time-out (See Figure).

The impact on patient outcomes is unknown and further study on that question is needed.

From the abstract presentations at SHM 14.

No comments: