Welcome to the Communities of Care Antimicrobial Stewardship Collaborative April 8, 2014 Carol Dietz, RN, MBA, CPHQ QI Consultant, Consulting Services, Qualidigm

Thank you to the CDC and the Connecticut Department of Public Health for making this important project possible. 2

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 4

Vision and Mission… Our Vision: Quality health care for all. Our Mission: Improving the quality, safety, and cost-effectiveness of healthcare through transformational change. 5

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 6

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 7

Our Services 8 Healthcare Quality Consulting Change Management Patient- Centered Medical Home Patient Safety Care Transitions Data Evaluation & Analysis Consumer & Provider Education Quality of Care Reviews

FarmingtonMiddlesexMeriden New Britain ECHNWaterburyDerbyBristol PutnamTorringtonNew Haven 9 Many thanks to the eleven participating Connecticut Communities of Care!

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 10 Why An Antimicrobial Stewardship Collaborative?

11 Why the Community Model? Home Health Long Term Care Facilities Assisted Living Physicians Nursing Homes Community-based organizations Hospitals

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 12

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 13

HAIs and Hospital Readmissions Patients 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* 14 *J. Furuno PhD, University of Maryland Medical Center Infection Control and Hospital 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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