antibiotics are medications too!!

Optimizing Medications: time to bring the pieces together

January 16 2014

Antimicrobial Stewardship:

Accreditation Canada Requirements

Heather Howley, MS

Accreditation Canada

© Accreditation Canada/Agrément Canada

Required Organizational Practices

(ROPs) in Qmentum

2

© Accreditation Canada/Agrément Canada 3

ROP Handbook

2014 ROP Handbook:

www.accreditation.ca

Full listing of ROPs,

including updated reference

material

http://www.accreditation.ca/


What is Antimicrobial Stewardship

Appropriate

selection,

dosing, route,

and duration of

antimicrobial

therapy

4


Aim of Antimicrobial Stewardship

Optimize the use of antimicrobials to achieve

the best patient outcomes

Reduce the risk of infections and reduce or

stabilize levels of antibiotic resistance

Promote patient safety

5


ROP Development

Key safety issue

Expert input

National Consultation

Expert Working Group

2013 inpatient acute care

2014 inpatient cancer,

inpatient rehabilitation,

complex continuing care

6


Antimicrobial Stewardship ROP

The organization has a program for antimicrobial

stewardship to optimize antimicrobial use.

7

Medication Management

Standards

© Accreditation Canada/Agrément Canada 8

Antimicrobial Stewardship

Program

Implementation

Accountability

Interdisciplinary Interventions

Evaluation


Implementation

9

The organization implements an

antimicrobial stewardship program. (Major)


Accountability

The program includes lines of accountability for

implementation. (Major)

10

Sure glad the hole isn’t at our end.


Interdisciplinary

The program is inter-disciplinary involving pharmacists, infectious diseases physicians, infection control specialists, physicians, microbiology staff, nursing staff, hospital administrators, and information system specialists, as available and appropriate. (Major)

11


Intervention

The program includes interventions to optimize antimicrobial use that may include (Major):

Audit and feedback,

A formulary of targeted antimicrobials and approved indications

Education

Antimicrobial order forms

Guidelines and clinical pathways

Strategies for streamlining or de-escalation of therapy

Dose optimization

Parenteral to oral conversion of antimicrobials

12


Evaluation

The organization establishes mechanisms to

evaluate the program on an ongoing basis,

and shares results with stakeholders in the

organization. (Minor)

13


During the On-Site Survey

14

REVIEW

TALK and

LISTEN RECORD

OBSERVE


Reference Material

15

Infectious Diseases Society of America and the Society for Healthcare

Epidemiology of America guidelines for developing an institutional

program to enhance antimicrobial stewardship.

MSH / UHN Antimicrobial Stewardship Program

www.antimicrobialstewardship.com

Public Health Ontario

http://www.oahpp.ca/services/antimicrobial-stewardship-program.html


Next Steps

Monitor implementation to improve ROP

language and approach over time

Feedback is welcome!

Work with partner organizations to support

organizations where necessary

Investigate options for antimicrobial

stewardship beyond the acute care sector

16

The leader in raising the bar for health quality

Le leader qui hausse la barre en matière de qualité de santé

antibiotics are medications too!!

Health & Medicine