Three of Atlantic Health System’s hospitals – Overlook, Morristown and Chilton medical centers – recently received the Gold Award in the first New Jersey Department of Health (NJDOH) Antimicrobial Stewardship Recognition Program (ASRP).
The Gold Award is the highest level of recognition in the program, which acknowledges local health care facilities’ efforts to enhance the appropriate, evidence-based use of antibiotics, prevent overuse, and in turn, reduce antimicrobial resistance.
Assistant NJDOH Commissioner and State epidemiologist, Dr. Christina Tan, and Dr. Aaron Rosenbaum, healthcare-associated infections and antimicrobial resistance epidemiologist, presented and recognized the recipients of the 2019 New Jersey Antimicrobial Stewardship Award at the NJ Antimicrobial Stewardship Collaborative Annual Conference hosted by New Jersey Hospital Association on December 5.
Dr. Tan stated, “At least 30% of antibiotics prescribed in the U.S. are unnecessary. This event highlights how much our healthcare facilities want to combat antibiotic resistance. Participation in this Antimicrobial Stewardship Program far exceeded our expectations.”
Antimicrobial Stewardship Programs (ASPs) and efforts to combat antimicrobial resistance have been ongoing in New Jersey for decades. In recent years, a framework from the Centers for Disease Control and Prevention (CDC), known as the Core Elements of Antimicrobial Stewardship, has been accepted as the “blueprint” for ASPs.
In supporting its partner organizations, the Communicable Disease Service (CDS) of the NJDOH developed the New Jersey Antimicrobial Stewardship Recognition Program to recognize healthcare facilities who have developed successful and sustainable ASPs using the Core Elements framework.
“By promoting appropriate, evidence-based use of antimicrobial medications and reducing over-reliance of these medications, we are able to not only achieve better outcomes for individual patients, but are also able to take make major steps at fighting bacterial resistance to antibiotics, which affects the broader community,” said Lauren Yedvab, Chief Operating Officer for Overlook Medical Center, who oversees pharmacy services throughout Atlantic Health System.
Antimicrobial stewardship team leaders at Overlook, Morristown and Chilton Medical Centers achieved the recognition through a variety of initiatives designed to ensure more effective and appropriate use of antibiotic medications or their alternatives. Some of these initiatives include:
- Management of sepsis: A multidisciplinary team effort to improve compliance to various actions associated with improving outcomes in patients with sepsis, including timely administration of appropriate antibiotic therapy
- Management of urinary tract and respiratory tract infections: The treatment of these infections accounts for a majority of hospital antibiotic use, so a multifaceted approach was undertaken, including development of diagnostic and treatment guidelines, provider education, and focused, real-time review of patients with these conditions to facilitate the appropriate initial antibiotic used, with timely step-down to narrow-spectrum oral antibiotics or discontinuation of antibiotics when appropriate
- Evaluation of penicillin allergy with penicillin skin testing: Penicillin allergies are one of the most reported antibiotic allergies among hospitalized patients, but true allergies occur in less than 5% of the population. With having a penicillin allergy label, alternative classes of antibiotics are commonly prescribed which may not be as effective as a penicillin or penicillin-like (i.e. beta-lactams) antibiotics and may also predispose patients to more adverse effects. The Overlook team specifically implemented a penicillin skin testing protocol that is performed by an allergist at the bedside in an effort to rule out and de-label penicillin allergies to allow practitioners to safely prescribe penicillin and beta-lactam antibiotics
- Optimization of microbiology reports: Microbiology culture and susceptibility results are important in guiding definitive antibiotic therapy once the bacteria causing the infection is identified. Antibiotic therapy should be modified to targeted, narrow-spectrum therapy when the identified bacteria is known to be susceptible to narrow-spectrum antibiotics in order to preserve the “good” bacteria within the body. Bacteria are tested against a variety of broad- and narrow-spectrum antibiotics. In order to assist providers in the selection of narrow-spectrum antibiotics, the antibiotic susceptibility reports were modified to display the results of broad-spectrum (or “big gun”) antibiotics only when the bacteria are resistant to narrow-spectrum antibiotics. This change led to a significant improvement in the selection of narrow-spectrum antibiotic therapy
The hospital pharmacy teams included:
- Overlook: Esther King, PharmD, BCIDP, and Robert Roland, DO, FACOI
- Morristown: Dimple Patel, PharmD, BCPS AQ-ID, BCIDP, Pamela Giordano, PharmD, BCPS, and Jason Kessler, MD, MPH
- Chilton: Alekhya Uppala, PharmD, BCPS, and Richard Krieger, MD
For more information on the New Jersey Department of Health (NJDOH) Antimicrobial Stewardship Recognition Program (ASRP), please visit: https://www.state.nj.us/health/cd/edu_training/ASP/asp_recognition.shtml
About Atlantic Health System
Atlantic Health System has a long-standing tradition of providing exceptional patient outcomes and experiences. Home to seven award-winning hospitals including Morristown Medical Center, the number one hospital in New Jersey according to U.S. News & World Report, Castle Connelly and Newsweek’s World’s Best Hospitals, the system has been ranked first in New Jersey in consumer preference by Monigle and first among health systems in New Jersey as a “best workplace” by both Modern Healthcare and Fortune Magazine.
Many of the system’s programs have received national accolades and designations, including Morristown Medical Center’s Cardiology and Heart Surgery program ranked among the top 30 in the nation by U.S. News and World Report; Morristown Medical Center’s Orthopedics program ranked among the top 35 in the nation by U.S. News and World Report and Atlantic Health System’s Cancer Care program, New Jersey’s first and only National Cancer Institute National Community Oncology Research Program. Additionally, Atlantic Health System Neuroscience at Overlook Medical Center, working with Atlantic Mobile Health, was the first in the nation to deploy and use portable Telestroke technology in ambulances for routine pre-hospital assessment of stroke patients.
Powered by a passionate workforce of 17,000 team members and 4,800 affiliated physicians dedicated to building healthier communities, Atlantic Health System serves more than half of the state of New Jersey, including 11 counties and 4.9 million people. The system provides care for the full continuum of health needs across a wide array of settings, including Atlantic Medical Group, one of the largest multi-specialty practices in New Jersey with more than 1,000 physicians and providers, 12 urgent care centers, Atlantic Rehabilitation Institute, Atlantic Home Care and Hospice and Atlantic Anywhere’s Virtual Visits. Facilitating connections between these services on both land and air is the transportation fleet of Atlantic Mobile Health.
With a clear sense of purpose and an unparalleled culture, Atlantic Health System attracts top leaders in the field of health care, from CEO Brian Gragnolati, who is currently Chairman of the American Hospital Association, to the numerous team members who serve as leaders across national clinical associations and research entities.