Welcome to the Communities of Care

Antimicrobial Stewardship Collaborative

April 8, 2014

Carol Dietz, RN, MBA, CPHQQI Consultant, Consulting Services, Qualidigm

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Thank you to the CDC and the Connecticut Department of

Public Health for making this important project possible.

Antimicrobial Stewardship Team Members

• DPH– Dr. Richard Melchreit, HAI Program Coordinator– Alessandra Litro, MPH, Health Program Associate– Richard Rodriguez, MPH, Epidemiologist 2

• Qualidigm– Ann Spenard, VP of Operations– Deb Quetti, Project Director– Carol Dietz, Project Lead– Shelia Eckenrode– Nicki Fazzi Hereford– Abby Dancause– Dan Qazi

Who are we?

Mission-driven, health

care consulting company

Experts in quality

improvement and patient

safety across the continuum

of care

Neutral convener/facilitator

Local and national

contract and grant work

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Vision and Mission…

Our Vision: Quality health care for all.

Our Mission: Improving the quality, safety, and cost-effectiveness of healthcare through transformational change.

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Background

• CT-based, brand recognized, healthcare consulting company with 30+ years of experience

• Medicare Quality Improvement Organization (QIO) for CT

• Patient Safety Organization designated by the CT Department of Public Health

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Our Customers

• Diverse group of healthcare stakeholders in government, industry and clinical practice

• Other clients include:– Agency for Healthcare Research and Quality– Rhode Island Department of Human Services– eHealthConnecticut (Regional Extension Center)– Academic institutions– National and international healthcare consulting firms– Local and national foundations– Healthcare providers in all settings– Payers and purchasers

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Our Services

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Healthcare Quality

Consulting

Change Management

Patient-Centered

Medical Home

Patient Safety Care Transitions

Data Evaluation &

Analysis

Consumer & Provider

Education

Quality of Care Reviews

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Farmington Middlesex Meriden New Britain

ECHN Waterbury Derby Bristol

Putnam Torrington New Haven

Many thanks to the eleven participating Connecticut Communities of Care!

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• To measure and promote appropriate use of antimicrobials by selecting an appropriate agent, dose, duration (the 3 rights of an AMS Program) to:– Improve patient outcomes– Minimize toxicity– Prevent emergence of antimicrobial resistance

Why An Antimicrobial Stewardship Collaborative?

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Why the Community Model?

Home Health

Long Term Care Facilities

Assisted Living

Physicians

Nursing Homes

Community-based organizations

Hospitals

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History of the Communities of Care• 2010 – 2012 Qualidigm – CHA Partnership

– Goal: to reduce preventable readmissions of patients with heart failure

– 25 hospitals– Hospital-based PDSA approach

• 2010 – Present Qualidigm Communities of Care– Goal: to reduce preventable all-cause readmissions – 18 hospitals, 88 NHs, 52 HHAs– Interactive Leadership Academies, individual training and

support, community support

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Community Successes

• Breaking down health care silos• Relationship building• Enhanced communication

between/across settings• Person-centeredness through

cross continuum care coordination• Identification of statewide issues• Sharing best practices

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HAIs and Hospital ReadmissionsPatients with + cultures for MRSA, VRE or C. difficile

(> 48 hours post hospital admission) were:

40% more likely to be readmitted within one year

60% more likely to be readmitted within 30 days*

*J. Furuno PhD, University of Maryland Medical Center Infection Control andHospital Epidemiology, June 2012

Kickoff Agenda

• Antimicrobial Stewardship Overview – Dr. Topal• CT Program Update – Dr. Melchreit• Project Overview – Carol Dietz• Breakout Session #1• Jeopardy• Breakout Session #2• Evolving Science: The Human Microbiome –

Dr. Koll

Handouts

• Agenda• CDC Vital Signs – March 2014– Making Health Care Safer; Antibiotic Treatment in Hospitals:

Proceed with Caution• Resource List• CDC Transfer Form• Ask/Offer form• SMART Worksheet and AIM Statement• Work Plan (sample of a completed work plan)• Evaluation

“If you want to go fast, go alone. If you want to go far,

go together.”-African proverb

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