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Are You an Antibiotics Steward or Deadbeat?

By Philip Betbeze  
   November 20, 2015


And hospitals and health systems aren't doing enough about it.

Hospitals, as they develop closer partnerships with post-acute care providers, are positioned to make key strides in antibiotic stewardship, says Kavita Trivedi MD, a consultant and former adjunct clinical professor of medicine at Stanford University School of Medicine.

"Focus on long-term care settings," she says. "It's an egregious situation happening in many nursing homes. On any one day, up to 8% of patients will be on antibiotics and patients have a 50% chance of being on them during a year."

She relates an example of a nursing home she recently worked with at which 104 patients were being treated with antibiotics for urinary tract infections even though only 8% of them met the clinical criteria for prescribing such drugs. That could be changed if nurses trained on antibiotic appropriateness were frequently monitoring the use of antibiotics at partner nursing homes, she adds.

"We are all at risk," Deveny says. "New levels of urgency, discipline, and rigor are required. Do we have the same ability as the bugs to adapt based on our environment?"

Unlike superbugs, healthcare is resistant to change.

"Clinicians are all very comfortable within our own silos and are well-intentioned, but we don't communicate and work together very well," he says. "As a physician, I was trained not to be accountable. If I screw up, I bring you back and I charge you again. How screwed up is that?"

You can access all the material from the speakers at the conference right here. It's worth your time, and your patients' health, to spend a little time on what they have to say about strategies to put to work in your organization right now.

"We're putting more and more people in danger and increasing costs," says Deveny. "Our promise to take care of you and not let you down is starting to fail."

Philip Betbeze is the senior leadership editor at HealthLeaders.

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