1. AHRQ Safety Program for Improving Antibiotic Use
Ambulatory Care

2. Presenter – Jeff Linder
Jeffrey A. Linder, MD, MPH, FACP
Professor of Medicine and Chief, Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine
Project address:

3. What Is the AHRQ Safety Program?
Collaborative intervention
AHRQ
Johns Hopkins Medicine
NORC
Overarching goals
Assist outpatient practices with reducing unnecessary antibiotic use
Enhance teamwork and communication around the diagnosis and treatment of infections and antibiotic prescribing
Improve patient safety and safety culture
Assist practices with enhancing workflow, especially during the busy cold and flu season
Maintain and improve patient satisfaction

4. Participating in the AHRQ Safety Program
1-year program begins in December 2019
FREE to participate
Open to the following types of practices taking care of adults or children:
Primary care practices
Urgent care clinics
Community-based health clinics
Specialty medical practices that provide primary care
Student health clinics
Electronic health record (EHR) required
Continuing medical education (CME) credits for physicians, physician assistants, and nurse practitioners
Maintenance of Certification (MOC) available for physicians

5. Educational Content
Access to infectious disease and primary care experts for coaching and troubleshooting
Monthly interactive Webinars
20 minutes long
Recorded and posted to the program Web site for 24/7 access
Slides and facilitator guides available for local use
Office hours
Optional calls for additional assistance
Once a month
Audio presentations

6. Webinar and Audio Presentation Topics
Why Your Practice Should Focus on Antibiotic Use and How Your Practice Is Doing With Antibiotic Prescriptions
Communicating With Your Patients
What Can You Learn From Your Antibiotic Prescription Data?
The Never Diagnoses: Upper Respiratory Tract Infections
The Never Diagnoses: Influenza
The Never Diagnoses: Acute Bronchitis
The Sometimes Antibiotics Diagnoses: Otitis Media
The Sometimes Antibiotics Diagnoses: Sinusitis and Pharyngitis
Usually Antibiotics Diagnoses: Community-Acquired Pneumonia
Developing a Consensus in Your Practice Around Symptomatic Treatment of Respiratory Tract Infections
Antibiotic Allergies: What Can You Actually Use?
Cellulitis and Skin Abscesses
Asymptomatic Bacteriuria and Urinary Tract Infection
Sustaining Antibiotic Stewardship Efforts

7. More Benefits of Participating
Additional educational content
Pocket cards and one-page documents that summarize existing knowledge and recommendations for common conditions for which antibiotics are prescribed in the outpatient setting
Educational material for patients and families
Commitment posters
Quarterly data benchmarking reports
Assistance with meeting the CMS MIPS requirements and demonstrating compliance with the new Joint Commission Ambulatory Antimicrobial Stewardship Standard
Certificates of participation in the AHRQ Safety Program for Improving Antibiotic Use

8. Four Moments of Antibiotic Decision Making
Does my patient have an infection that requires antibiotics?
Do I need to order diagnostic tests?
If antibiotics are indicated, what is the narrowest, safest, and shortest regimen I can prescribe?
Does my patient understand what to expect and the followup plan? 

9. What Do Participating Practices Need To Do?
Identify a clinician and administrative lead
Participate in Webinars and audio presentations
Work with your practice to identify areas to improve antibiotic prescribing and incorporate proposed changes into clinical practice
Submit requested data to the program Web site
Time commitment:
3 hours per month
1 hour on Webinars and/or audio presentations
2 hours on local, collaborative meetings to translate the content from the Safety Program into practice at your site, and calling into Office Hours

10. Data Required From Participating Practices
Monthly data on patient visits
Monthly data on number of antibiotic prescriptions, by antibiotic
Monthly data on number of patients with respiratory infections (certain ICD-10 codes)
Monthly data on number of patients with a respiratory condition and prescribed antibiotics
Data collection period: 9/2019–12/2020

11. Other Data Required From Participants
Structural assessment at the start and end of the Safety Program
Medical Office Survey on Patient Safety (MOSOPS) at the start and end of the Safety Program

12. Timeline for Participation
September 2019 –
November 2019
December 2019 –
November 2020
Identify clinical and administrative leads within your ambulatory care practice
Participate in educational programs including the onboarding/orientation Webinar series, audio presentations, and educational Webinars
Complete Ambulatory Care Team Letter of Commitment
Regularly meet as a team to implement interventions and monitor performance
Register your team to use the program Web site/data portal
Collect and submit data

13. Safer Health Care for Current and Future Generations

14. To Learn More and Enroll
Visit our Web site:
Complete the online application on the Web site
with any questions

15. THANK YOU FOR PARTICIPATING!
Questions
Type in your questions using “Chat” or
Speak up on conference line
THANK YOU FOR PARTICIPATING!