Description
2021/2022 summary
- Education provided by UW epidemiologist and did presentation to med staff
- ASB video posted internally and added to orientation to new providers
- ED medical director champion supports training and ASB education efforts
- Charts have references to ASB education and changes
- Attestation form for residents re: ASB education
2022/2023 – goals
- Medical director transitioning – new ED director arriving in July 2023
- More investigation into inpatient practices
- Operationalize education for incoming residents and physicians and providers for sustainability
- investigate potential revisions for UA reflex criteria
For third year, would be interested in focusing on duration
Project Resources
Columbia final ASB Report 8.22.23
Core Elements
Education
Educating clinicians about resistance and optimal prescribing.
Leadership Commitment
Dedicating necessary human, financial and information technology resources.
Reporting
Regular reporting information on antibiotic use and resistance to doctors, nurses and relevant staff.
Tracking
Monitoring antibiotic prescribing and resistance patterns.
PDSA Cycles
Progress on PDSA Cycle 1
- Submit data to the UU form.
- Connect with Gritman team re: UA reflex criteria
March 2023:
- Current UA reflex is positive LE moderate to many bacteria, less than 10 squam
- Learned residents no longer do onboarding due to COVID. Will restart asap.
- Connect with Copper Queen and WhidbeyHealth for Dear Dr. letter
- Create Dr. Doctor letters for 3 high prescribing ED providers
- ED provider onboarding for residents
- Continue to collect data
- Provide education to ED providers on difference between UTI treatment algorithm and data collection algorithm
5/25 check-in
- Recent challenges with data collection: positive urine cultures data coming in slower
- ED focus is going well
- From June 2020 – January 2023 appropriate treatment rate = 65%; consistent despite provider specific education
- If 3 highest prescribing providers removed from data set, appropriate treatment rate = 78%
- Currently (March 2023) collecting ED UAs and majority are treated on pyuria rather than cultures. (ED UAs are being collected outside of the IQIC 201 redcap survey)
- Estimate at least 35% of ED patients are being treated on UA alone
5/25
- Chart of providers and appropriate antibiotic use percentage comparing 2022 to 2023
- Difficulty with NQF/Utah algorithm not aligning with TASP algorithm originally used (research contribution is separate from ED focused project)
- Performance seems consistent between both
5/25
- Will send out Dear Doctor letter – ED director will hand out and have discussion
- Look at changes over time
- Providers with high volumes of cases show more reliable trends
- Send letters for providers that improved