By Debbie Ritenour, Vitals contributor
SACRAMENTO, Calif. – The California Department of Public Health recently named Sutter Lakeside Hospital a member of the state’s Healthcare-Associated Infections Antimicrobial Stewardship Honor Roll at the silver level. With this achievement, every acute-care hospital within the Sutter Health system has now earned this coveted distinction.
“Earning Honor Roll designation is no small feat,” said Dr. Jeffrey Silvers, medical director of pharmacy and infection control for Sutter Health. “Every level is difficult to obtain. You really have to prove that you’re doing stewardship and that you’re doing it at a level the state considers worth noting.”
Among Sutter Health acute care hospitals, five are bronze-level members, 11 are silver-level members, and six are gold-level members. The designation period is three years.
Antimicrobial stewardship is a critical component of safe patient care. The misuse and overuse of antimicrobials, including antibiotics, is one of the most pressing health issues in the world and a leading cause of antibiotic resistance. Antibiotics also can have side effects such as diarrhea, yeast infections, Clostridioides difficile, or C. diff, infections and allergic reactions, complicating patient care. According to the Centers for Disease Control and Prevention approximately 50 percent of antibiotic regimens in hospitalized patients are inappropriate in some way.
Antimicrobial stewardship programs promote the appropriate use of antimicrobials, thereby improving patient outcomes and decreasing antibiotic resistance. Ultimately, these programs can help hospitals reduce length of stay and lower costs.
Applying for the Antimicrobial Stewardship Honor Roll is a rigorous process. Applicants must document that their antimicrobial stewardship program embodies each of seven core elements: leadership commitment, accountability, pharmacy expertise, action, tracking, reporting and education. Silver applicants must also demonstrate outcomes of interventions/projects, and gold applicants must demonstrate both outcomes and engagement with community partners. Applications then undergo a three-phase review process that includes external blinded reviewers.
“A health system may not apply for membership,” said Lisa Hammer Rieg, doctor of pharmacy and clinical coordination pharmacist for infectious diseases and antimicrobial stewardship for Sutter formulary management and clinical programs. “Each and every hospital has to apply individually. Each hospital also has its own program, but they all share similar components.”
These components include a multidisciplinary program committee that oversees the hospital’s efforts. Each committee has a pharmacist lead and a physician lead as well as representatives from administration, nursing, infection prevention, laboratory and other departments.
“What I love about our antimicrobial stewardship programs is that they’re really collaborative. There’s effort and enthusiasm not only from the pharmacists, but also from the different disciplines,” Rieg said. “The physicians are very integrated with the committee. They all voice their opinions, give suggestions and review what needs to be reviewed. It trickles down to the other members.”
Sutter leadership has made antimicrobial stewardship a priority. In addition to the individual hospital committees, Sutter has a system antimicrobial stewardship committee and a system antimicrobial stewardship pharmacists committee.
“Not many systems provide the administrative support that Sutter does,” Rieg said. “We can drive a lot of the effort, but the support is key.”