Welcome to the GHA Infection Prevention Power HourDecember 19, 2013

Brief Agenda

GHA/HEN Update Review of CMS, Georgia HAI Reporting for

2014 Georgia DPH Update – Antibiotic Stewardship

Program GMCF, QIO Update – NHSN Reporting: CDI

How Are We doing at Preventing Infection Harm?

CAUTI Still A Challenge

SSI: Colon

SSI Abdominal Hysterectomy

Coming

• Hospital wide CLABSI and CAUTI• Additional SSI: Hip and knee prosthesis• VAE: IVAC, Possible, probable VAP

LEAPT to GAPP

Innovation for rapid safety improvement Sepsis C. diff with antimicrobial stewardship

Stepping up to Antibiotic Stewardship in Georgia

Jeanne Negley, MBAGeorgia HAI Coordinator

Georgia Department of Public Health

Georgia Hospital Association Infection Prevention Power HourDecember 19, 2013

Impetus to Engage in Stewardship Awareness of stewardship work conducted

in Oregon New to Georgia (with no program for

stewardship) Need for state to engage with providers in

prevention activities

Activities Convened subcommittee

Recommended: Create statewide strategic plan Conducted research on resources and evidence of

resistant disease in the state:• Within the State HD: Emerging Infections Program,

Gonococcal Isolate Surveillance Project, Vaccine Preventable Disease, Evaluation Resources

• Outside the State HD: Centers for Disease Control and Prevention (subject matter and evaluation experts), South Dakota, and Maryland

Initial Results Developed statewide strategic plan

Initial focus on acute care Logic Model

Adapted from CDC DHQP logic model Policy implementation through partnerships Phased-in approach

Recognition Program for Antibiotic Stewardship

Association of State and Territorial Health Officials (ASTHO) Grant

Opportunity Applied for and received ASTHO HAI

Capacity Grant “Changed Gears” to focus on training for

acute care pharmacists and physicians Grant Activities:

Developed ASP assessment tool with CDC October 9, 2013 training for pharmacists Conducted post-training focus group with pharmacists Physician webinars scheduled for December 2013

October 9, 2013 A lot of people in one room Challenge of partial government shutdown

Georgia Antibiotic Stewardship Subcommittee members step up to the challenge

Jeanne conducts focus group

Meeting runs over time; extended Q&A session

Focus Group QuestionsWhat did you like most/least about training?

What is one most useful idea of technique you learned today?

What are the barriers to antimicrobial stewardship programs (ASP)?

What can the State Health Department do to help promote enhance … ASP?

Initial thoughts on Honor Roll?

Anything we have

not discussed?

Physician Training One-hour webinar offered on three dates

Dec. 9, 11, and 12 (noon and 5 pm) Program highlights need,

hospitalist/community program, ASP for larger facility

Live Q&A session for each broadcast CMEs through Emory

Preliminary Assessment Data

26 of 50 facilities had a multidisciplinary committee focused on antimicrobial use

• 19 (73.1%) reported physician or pharmacist leader for stewardship activities

• 4 (15.4%) have neither physician nor pharmacist leaders

• 3 (11.5%) did not meet regularly

Preliminary Focus Group Data Participants like the training: speakers,

content, format Wanted more education:

Supported for pharmacists and physicians Partner with pharmacy and medical schools

Supported Honor Roll program Need to be sensitive of resources at smaller facilities

Existing Partners to Support our Work HAI Advisory Committee and Antibiotic

Stewardship Subcommittee Development of Honor Roll; Created Toolkit; Speakers

Bureau; Development of new partnerships Georgia Hospital Association, Quality

Improvement Organization, Georgia Infection Prevention Network Marketing training; Development of new partnerships

Centers for Disease Control and Prevention Assessment tool Focus group questions Subject matter consultation

New Partnerships Developed Georgia Society of Health System

Pharmacists and Emory School of Medicine Marketing, continuing education, sustainability (pharmacy

association) Medical Association of Georgia, Atlanta

Infectious Disease Society, Atlanta Chapter of Hospital Medicine Marketing training

Potential Future Partners: state pharmacy and medical schools To offer antimicrobial stewardship training to

pharmacists and physicians

• The Georgia HAI Advisory Committee and Antibiotic Stewardship Subcommittee are developing an honor roll to recognize facilities engaged in stewardship.

• The requirements of the Honor Roll support the stewardship principles and tools provided in pharmacists and physician training programs.

Georgia Honor Roll for Antibiotic Stewardship

STEPPING UP TO ANTIMICROBIAL STEWARDSHIP IN GEORGIA

Phase 1- Engagement:1. Letter of Commitment from Leadership2. Antibiotic Stewardship Team3. Educational Event

Phase 2- Implementation4. Antibiotic Stewardship Programs5. Measurement of Impact of Program

Elements of Honor Roll

STEPPING UP TO ANTIMICROBIAL STEWARDSHIP IN GEORGIA

AcknowledgementsGeorgia Department of Public HealthMatthew CristStephanie Lambert (former intern)Lauren LorentzsonMichele MindlinAshley MooreMelissa Tobin D’AngeloNadine Oosmanally

Georgia Antibiotic Stewardship SubcommitteeJesse Jacob, MD, MS, Emory University Hospital, co-chairRenee Watson, RN, CIC, Children’s Healthcare of Atlanta, co-chairAngelina Davis, PharmD, MS, BCPS (AQ-ID) WellStar Health SystemDenise Flook, RN, CIC, Georgia Hospital AssociationKimberly Hazelwood, PharmD, Georgia Department of Public HealthSheena Kandiah, MD, Emory University Hospital

Armando Nahum, SafeCare CampaignCindy Prosnak, RN, CIC, Georgia Medical Care FoundationCraig Smith, MD, University Health System, Augusta

Centers for Disease Control and PreventionLoria PollackRonda Sinkowitz-CochranHeidi GruhlerArjun SrinivasanSusan FullerTurquoise Griffith

ASTHOCatherine CairnsVirginia Dolen

• Kathryn Arnold, MD, Centers for Disease Control and Prevention• Ryan Deal, Georgia Department of Public Health• Marcia L. Delk, MD, MBA , WellStar Health System • Denise Flook, RN, MPH, CIC, Georgia Hospital Association • Jesse T. Jacob, MD, MSc, Emory University Hospital Midtown• Robert C. Jerris, PhD, D (ABMM), Children’s Healthcare of Atlanta/Emory School of Medicine• Mary Key, BSN, CIC , Tift Regional Medical Center• Denise Leaptrot, BSMT(ASCP), RN, CIC, MBA , Coliseum Medical Centers• Peggy McGee , RN, CIC, Liberty Hospital• Armando Nahum , SafeCare Campaign• Cindy Prosnak, RN, CIC , Alliant/Georgia Medical Care Foundation• Susan M. Ray, MD , Emory School of Medicine• Lynn A. Reynolds, RN, CIC, Southeast Georgia Health System • Craig E. Smith, MD, MS, CTropMed, FACP, FIDSA, University Health Care System• James P. Steinberg, MD , Emory University School of Medicine • Nimalie Stone, MD, Centers for Disease Control and Prevention• Robert Thornton, MPH, Georgia Department of Public Health (District 9-1) • Renee Watson, BSN, RN, CIC, Children’s Healthcare of Atlanta• Rebecca Walker, RN, CIC, Georgia Regents University

Georgia HAI Advisory Committee

Thank you!

Jeanne Negley, MBAGeorgia Department of Public Health

2 Peachtree Street, NW, #14-225Atlanta, GA 30303

404-657-2593jenegley@dhr.state.ga.us

Alliant/GMCF/QIO Update

Cindy Prosnak

Contact Information Denise M. Flook, RN, MPH, CIC

Georgia Hospital Association770-249-4518, dflook@gha.org.

Jeanne Negley, HAI CoordinatorGeorgia Dept. of Public Health(404) 657-2593 | jenegley@dhr.state.ga.us.

Cindy Prosnak, RN, BSN, CIC Alliant GMCF706.836.8361 | CProsnak@gaqio.sdps.org.