ANTIBIOTIC STEWARDSHIP OPERATIONALIZED: EMR-FACILITATED IV TO PO CONVERSIONS

4^th International Conference on Medical Informatics & Telehealth

October 6-7, 2016 | London, UK

Steven H. Shaha

Center for Public Policy & Administration, USA

Posters & Accepted Abstracts: J Health Med Informat

Abstract :

Background: Antibiotic Stewardship is a crucial imperative, yet all-too-often elusive to operationalize. Intravenous (IV) therapy for hospitalized patients is common practice, particularly for patients sufficiently ill to require hospitalization. However, medications providing oral (PO) bioavailability alternatives allow for therapeutic IV to PO conversions for reduce cost-per-case and length of stay (LOS), and improved stewardship, Evidence shows that appropriate conversions from IV to PO have decreased LOS by 1.53 days with average medication-related cost-per-case $15,149 savings. Methods: Physicians, pharmacists and IT-professionals teamed to define bioavailability alternative antibiotics appropriate for IV to PO conversions, and then designed optimal within-EMR computations triggering alerts recommending conversions. Pharmaceuticallypertinent guidance indicated 12 appropriate antibiotics. Pre-versus-post prospective study of patterns contrasted a 12-month baseline versus month-to-month post-implementation. Results: Post-implementation from baseline 85%-to-15% IV-versus-PO mix (all p<0.001): � 68%-to-32% mix within 4 months, sustained for 6 additional � 11.4% decreased IV-associated infections � 36.8% decreased LOS due to earlier discharges with PO management. � 6.8% lower cost-per-case, with 14.1% less IV costs, 42.5% more in PO costs. � Thus $3,300 lower cost-per-antibiotic-case per discharge. Conclusions: Antibiotic stewardship, and other medication-related undertakings, can be made more tangible and manageably operationalized through EMR-enabled strategies like IV to PO conversions. A 6.8% reduced cost-per-case totaled over $30,000 in the first 4 months in this organization. Shortened loss also mean improved facility capacity without bricks-and-mortar, and sooner patient capability for self-management.

Biography :

Email: steve.shaha@att.net