Dr. Ed Septimus, a board-certified physician from Texas A&M and Harvard, and Whitney Buckel, an antimicrobial stewardship expert at Intermountain Health, discuss innovative EHR tools for improving antibiotic use. They share insights on optimizing antibiotic order systems and managing penicillin allergies within EHRs. The duo emphasizes the importance of real-time alerts and collaboration for enhancing patient safety. Additionally, they reveal exciting details about the INSPIRE trials, showcasing advancements in healthcare through technology.
Optimizing Electronic Health Records (EHRs) through tailored reminders and standardized order sets can significantly enhance antimicrobial stewardship practices.
Integrating clinical guidelines into EHR functionalities is crucial to support effective antibiotic prescribing while ensuring adherence among healthcare providers.
Diagnostic stewardship, supported by EHR checks prompting necessary tests before antibiotic orders, is essential for targeted therapy and reducing unnecessary usage.
Deep dives
Optimizing Electronic Health Records for Antimicrobial Stewardship
The episode discusses strategies to optimize Electronic Health Records (EHRs) to facilitate better antimicrobial stewardship practices. Key insights include the necessity of incorporating mandated questions during order entries to capture accurate antibiotic indications. Adjusting order sentences to account for dosing strategies enhances compliance with clinical guidelines while also making it easier for healthcare providers to select appropriate therapies. A recent study highlighted the positive impact of tailored order sets, demonstrating a reduction in unnecessary antibiotic usage through structured reminders and interdisciplinary collaboration.
Role of Clinical Guidelines in Antibiotic Stewardship
The discussion emphasizes the importance of integrating clinical guidelines into EHR functionalities to support antibiotic prescribing. It highlights the challenge of ensuring that such guidelines are used effectively and that healthcare providers are encouraged to adhere to them consistently. Collaborative initiatives, such as implementing educational reminders and tracking usage, are essential to enhance adherence to best practice guidelines. Additionally, one study showcased that utilizing standardized order sets in EHRs can significantly improve empiric antibiotic selections while promoting interdisciplinary teamwork.
Overcoming Challenges in Medical Decision-Making
A critical point is raised regarding the need for healthcare providers to maintain clinical judgment despite relying on order sets from EHRs. While standardized prompts can streamline decision-making, they must not replace thoughtful consideration of each patient's unique circumstances. The conversation recalls instances where generic order sets led to inappropriate antibiotic choices, particularly in cases of sepsis, and advocates for designing prompts that enhance cognitive engagement rather than just facilitate rote responses. It underscores the balance between technology and clinician expertise to optimize patient outcomes effectively.
Impact of Diagnostic Stewardship on Antimicrobial Prescribing
The importance of diagnostic stewardship as a complement to antimicrobial stewardship is a focal theme in the episode. Ensuring accurate diagnoses before initiating treatment is crucial to avoid the misuse of broad-spectrum antibiotics. For instance, the discussion mentions the necessity of conducting diagnostic tests, such as cultures, before administering antibiotics in clinical scenarios like septic patients. Implementing checks within EHRs to prompt for necessary diagnostic steps before antibiotic orders can significantly improve targeted therapy and reduce unnecessary antibiotic usage.
Engaging Hospital Staff in Stewardship Initiatives
The episode highlights strategies for effectively engaging healthcare professionals in antimicrobial stewardship initiatives. Building relationships with key stakeholders and customizing educational approaches based on local hospital cultures are critical for success. The speakers share experiences of working with clinicians to address specific concerns, such as understanding the implications of antibiotic allergies or the need for de-escalation after initial therapy. These personalized interactions foster a collaborative environment where clinicians feel invested in stewardship efforts, ultimately leading to improved patient care.
Drs. Ed Septimus and Whitney Buckel join Dr. Jeannette Bouchard for our second episode in the series “Stewie Struggles.” In this episode, we focus on interventions within the EHR and what we can do on the end-user side of antimicrobials. We discuss how to use unique tools within the EHR and get a VIP look at the efforts to pull off the amazing INSPIRE trials! You don’t want to miss this!
