Hospital infection control experts have been working hard to reduce or limit the growing problem of antibiotic-resistant bacteria.
A new action plan produced by the Obama administration outlines new steps for hospitals to take in that regard, some of which, over time, will be required as a Condition of Participation in the Medicare program.
Though the plan has been expected, because it results from an Executive Order issued last year, the specific provisions include several pertaining to the hospital field that may necessitate some measurable changes in operations and national outcomes.
"It'll be a huge challenge," said Bea Dys, executive director of clinical program development for Comprehensive Pharmacy Services, a pharmacy management company.
Among the actions the plan calls for within one year are:
• Tracking hospitals that have antibiotic stewardship programs through the National Healthcare Safety Network, the nation's most widely used health care-associated infection tracking system
• A review of existing antimicrobial stewardship regulations, with the goal of adding new ones if deemed necessary
• Optimization of the standards for antibiotic stewardship programs
The Obama administration document also calls for changes to occur within three years, including the creation of a requirement that hospitals have an antibiotic stewardship program to qualify as a provider in the Medicare program. The requirement also would apply to long-term acute care hospitals, other post-acute care facilities, ambulatory surgery centers and dialysis centers.
Dys said some specific targets for reducing national infection rates are among the plan's bigger challenges for the field. Included in that are a targeted 50 percent reduction in the incidence of Clostridium difficile infections and a 60 percent reduction in carbapenem-resistant Enterobacteriaceae infections acquired during hospitalization.
Hospitals already are in a better position than they were a few years ago, with a growing number having dedicated stewardship programs, said John Combes, M.D., chief medical officer and senior vice president for the American Hospital Association. Key to the success of such programs is having a strong physician leader to champion the effort, a clinical pharmacist to monitor usage of antibiotics and a system to enable that monitoring, Combes said. "The issue is to make sure that you have a targeted approach to antibiotic usage that reflects the sensitivities of the organization," he said.
Resources for hospitals that seek to boost their stewardship capabilities are available, including a toolkit developed by the AHA with resources from seven other organizations. And you can learn about specific procedures being employed at four hospitals that participated in an AHA Physician Leadership Forum roundtable last year.
The Centers for Disease Control and Prevention, which sounded an alarm on the matter in 2013, is leading much of the work to eliminate antibiotic-resistant bacteria. CDC offerings include immediate assistance like the Get Smart for Healthcare online resource, and longer-term applied research being performed through its Prevention Epicenters.