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Abstract Number: 194
SHM Converge 2024
Background: Inappropriate diagnosis of urinary tract infections (UTI) contributes to antibiotic overuse. We previously validated and refined a patient safety measure that defines inappropriate diagnosis of UTI (i.e., treatment of asymptomatic bacteriuria [ASB]) and was endorsed by the National Quality Forum. Use of this measure as a pay-for-performance metric in the Michigan Hospital Medicine Safety […]
Abstract Number: 206
SHM Converge 2023
Background: Closing the gap between evidence-supported antibiotic use and prescribing patterns among clinicians is a vital component of curbing excessive antibiotic use, a practice that fosters antimicrobial resistance and exposes patients to the side effects of antimicrobial agents. Providing medication prescribing information via scorecard has been shown to improve clinician adherence to quality metrics in […]
Abstract Number: 230
Hospital Medicine 2020, Virtual Competition
Background: Antibiotics prescribed at hospital discharge account for over half of antibiotic exposure related to hospitalization and contribute to antibiotic-related harm. We hypothesized that an antibiotic timeout to reconsider antibiotic necessity, selection, and duration prior to discharge could reduce antibiotic overuse. Thus, we conducted a 6 month prospective, controlled pilot study to determine feasibility and […]
Abstract Number: 235
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: Clostridioides difficile infection (CDI) can be prevented through infection prevention practices and antibiotic stewardship. We found in a 2013 national survey (571 hospitals, 71% response rate) that while infection prevention practices for CDI were common in U.S. hospitals, only 52% had an antibiotic stewardship program (ASP). On 1 January 2017, The Joint Commission required […]
Abstract Number: 242
SHM Converge 2024
Background: Laboratory testing is one of the highest volume medical activities in a health system. Despite their central role in driving clinical decision making, laboratory diagnostics are highly variable and expensive. The annual cost estimate in the U.S. for low value screening, testing, or procedures range from 17.2 billion to 27.9 billion dollars.1 Excessive laboratory […]
Abstract Number: 246
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: In 2011, the Infectious Diseases Society of America (IDSA) published new guidelines on the management of community acquired pneumonia (CAP) in children and recommended use of narrow spectrum antibiotics such as ampicillin or amoxicillin over broader spectrum antibiotics such as ceftriaxone. Many studies have shown that these guidelines have been adopted with varying success […]
Abstract Number: 249
Hospital Medicine 2020, Virtual Competition
Background: In an effort to combat the national opioid crisis, our state legislation passed House Bill 451 effective July 1, 2019. It addresses medication overprescribing to decrease morbidity and mortality from opioid misuse, abuse, and overdose. The law has several requirements including discussion of non-opioid treatment alternatives, review of the Prescription Monitoring Drug Program (PDMP) […]
Abstract Number: 250
SHM Converge 2024
Background: Healthcare expenditures in the US have been increasing at an unsustainable rate, and thus there is a strong interest in resource stewardship of low-value diagnostic tests. At our institution, internal data, as well as The Vizient™ Clinical Data Base, showed high utilization of inpatient daily labs (complete blood count (CBC), basic metabolic panel (BMP) […]
Abstract Number: 252
Hospital Medicine 2016, March 6-9, San Diego, Calif.
Background: Curbing antibiotic overutilization has become a priority in hospitals attempting to address the growing problem of antimicrobial resistance. One strategy being endorsed by Antibiotic Stewardship Programs is the adoption of an “antibiotic timeout,” during which the pharmacist reviews the appropriateness of the regimen every 72 hours. We elected to challenge hospitalists to perform a […]
Abstract Number: 261
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: Growing antimicrobial resistance, C. difficile infection and cost have triggered a greater reliance on antimicrobial stewardship. Most stewardship models rely upon a central team, often led by ID specialists, to oversee prescribing in an institution. However, there are limitations to this paradigm. Purpose: We believe opportunities exist for hospitalists to drive stewardship by integrating […]