Program Improves Health and Save Costs

Program Improves Health and Saves Costs

Creighton and its clinical partner in Nebraska and Iowa, CHI Health, piloted a successful program to improve health outcomes, save costs and reduce hospital readmissions due to infection.

As the pipeline for antibiotics is decreasing and antibiotic resistance is increasing, health care providers are turning attention to the wisest use of antibiotics. Antimicrobial stewardship was mandated in January 2017 by the Joint Commission, the U.S. health care accrediting organization.

The Creighton team was ahead of the curve, initially implementing an Antimicrobial Stewardship Program (ASP) at Creighton University Medical Center beginning in 2011; because of the program’s success, it has been used throughout the CHI Health system, which includes 14 hospitals in the region.

“The positive results and success made the program a natural fit to continue when CHI Health Creighton University Medical Center-Bergan Mercy became the primary teaching hospital for the health system,” says Renuga Vivekanandan, MD, director of hospital epidemiology and the ASP. The expansion to all CHI Health hospitals brought the program to facilities of all sizes, including those in rural communities.

The ASP consists of a collaborative team that includes physicians, pharmacists, microbiologists, nurses and others. It focuses on reducing patients’ readmission to hospitals from infection with Clostridiodes difficile, also called C. difficile, a bacterium that causes serious gastrointestinal illness, including life-threatening colon inflammation. Older adults in hospitals or long-term care facilities who have taken antibiotics are particularly at risk.

The CHI Health ASP research study found an immediate impact on patient care and safety and a sizable reduction in readmission for C. difficile, to the tune of about $1.3 million in one year.

Jennifer Petersen Anthone, PharmD’08, was the study’s lead author and is the ASP pharmacist and Pharmacy Residency Program director at Creighton University Medical Center-Bergan Mercy. “The pharmacy residents are exposed to antimicrobial stewardship daily during multiple rotations,” Anthone says, “and also can take an antimicrobial stewardship elective for further training.”

Pharmacy residents are not the only Creighton health professional trainees who benefit from the program. Members of the ASP also work very closely with School of Medicine learners, including medical residents and students, in addition to pharmacy and nursing students.

“We provide real-time education to providers on antimicrobial therapy and work collaboratively to deliver the best patient care possible,” Anthone says.

Awareness of the ASP program is spreading, as members of the team have presented at national infectious disease meetings. Catholic Health Initiatives (CHI) facilities in other states are considering expanding antimicrobial stewardship services modeled after the success of the Creighton-CHI Health team.