To meet all federal, state, CDC and Joint Commission guidelines and mandates, Methodist Hospital of Southern California used its electronic health records system to help build its own in-house antimicrobial stewardship program.
The hospital moved from a time-consuming, paper-based system with incomplete tasks to now completing mandated antibiotic rules on all patients in less than four hours. Hospital staff accomplished this through the in-house creation of custom health issues in its EHR, from vendor Allscripts, to develop advanced patient lists and searches for specific criteria of antibiotic use.
[Also: EHRs in the cloud: Why smaller healthcare providers are making the leap]
Advanced patient lists consist of an antibiotic review of all patients after 48 hours, 7 days and 3 or more antibiotics plus a notification for IV to oral conversion.
“We optimized and automated these functions with a series of custom medical logic modules, informational columns and an easy to read clinical summary view,” said David Ratto, MD, a pulmonary and critical care specialist and a hospitalist at Methodist Hospital. “The end product allowed pharmacists to complete antimicrobial review of all patients, increased pharmacists interventions by 48 percent and decrease our most common antimicrobial usage by 20 percent.”
[Also: Shawnee Mission Medical Center hits Stage 7 in HIMSS Analytics EHR adoption model]
Ratto said the hospital and the staff working on the program learned a variety of lessons coming away from the in-house creation.
“There is an absolute need to have good communication and cooperation between the various departments,” he said. “It was not uncommon that IT did not know the needs of pharmacy and pharmacy did not know the capabilities of what IT could provide. Our project was a cooperative effort between infectious disease physicians, pharmacy, IT and infection control.”
Another lesson learned was the importance of champions representing the project and their departments.
“Unfortunately, during the course of the development of our program, our infectious disease champion died,” he said. “It is extremely difficult to replace a person who acts as a champion for a project. We continue to have issues for the vision aspect. This is even so when a very competent person takes over. They may lack the vision and passion for the project.”
Ratto stresses the importance of an antimicrobial stewardship program in today’s healthcare environment.
“Antimicrobial stewardship is mandated by the Joint Commission, many state agencies and other regulatory agencies,” he said. “This is an extremely important topic because not only did we save our hospital a significant amount of money through our program but we have shown marked quality improvement by decreasing rates of MRSA and C. difficile infections, improved antibiotic sensitivities and decreased readmissions.”
David Ratto will be speaking in the HIMSS18 session, “Creating an EHR-based antimicrobial stewardship program,” at 2:30 p.m. March 8 in the Venetian, Delfino 4004.
Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com