Salud29 enero, 2020|Actualizadojunio 23, 2020

Case study: Aultman Hospital improves antimicrobial stewardship and saves $2 million

As drug costs continue to rise, hospitals are realizing that pharmacists can help contain spending and improve margins with the right teams and technology solution in place. 

Enhancing antimicrobial stewardship to improve clinical outcomes and reduce costs 

Aultman Hospital, part of a 1,032-bed not-for-profit academic hospital system located in Ohio, approached Wolters Kluwer for assistance with implementation of an antimicrobial stewardship program (ASP), among other pharmacy initiatives. Aultman was responding to Joint Commission requirements and the hospital’s own focus on improving clinical outcomes and reducing costs. 

To address the goal of using its ASP to improve clinical outcomes, the director of pharmacy sought a sophisticated clinical surveillance solution, one that integrated into the pharmacy workflow, aggregated EHR data, and removed manual processes to ensure efficiencies and open time for staff pharmacists to collaborate with physicians on patient care. The solution would also need to quickly identify patients on the wrong antibiotics or opportunities to de-escalate broad spectrum agents to ones more aligned with culture results. These key tactics were identified to reduce spend on high-cost drugs, improve patient care and to reduce antimicrobial resistance.

In addition, Aultman began embedding staff pharmacists into the hospital care teams to create better partnerships between pharmacists and physicians. Sentri7’s evidence-based clinical decision support capabilities provided these clinicians with real-time alerts so they could respond quickly to improve care. 

Matt Baldwin, Pharm.D, the hospital’s current executive director of pharmacy explains Aultman Hospital’s success, “Sentri7 gives us information tailored to what we in pharmacy need to see so we can really target certain patients. We’re only limited by the granularity of the information available through our EHR and whether it’s real-time. Also, it can take months to get a report built with the EHR. We have a list of initiatives—such as renal dosing, anticoagulation activity and IV-to-PO conversions—that we need to move forward. Sentri7 allowed us to ramp up quickly,” Baldwin added.

Utilizing Sentri7 to track and improve ASHP performance 

Aultman Hospital selected Wolters Kluwer’s Sentri7® Pharmacy surveillance solution which enabled leadership to regularly track overall antibiotic spending, particularly on high-cost and broad-spectrum antibiotics like daptomycin. To aggregate essential data, Aultman integrated Sentri7 within its EHR and set up antimicrobial stewardship rules and workflows to support the hospital’s goal of tracking and improving its ASP performance. As a result, Sentri7 rules helped prioritize patients in real-time in a centralized dashboard to take the guesswork out of where the pharmacy team could make the biggest impact on care.

Sentri7 gives us information tailored to what we in pharmacy need to see so we can really target certain patients.
Matt Baldwin, Pharm.D, Executive Director of Pharmacy

The result? Nearly $2 million in cost savings

Implementation of Sentri7 and process change drove a number of important results for Aultman. 

Physician acceptance rate for antimicrobial stewardship interventions hit approximately 95 percent, demonstrating a high level of trust between the physicians and pharmacy. “In large part, that’s due to Sentri7 being in place,” Baldwin added. 

Perhaps most important, after implementing Sentri7 with Wolters Kluwer, Aultman Hospital calculated its antibiotic expenditure and was then able to set targets for reducing and improving that spend. Over five years, the hospital saved close to $2 million through the reduction in use, days of drug therapy and switching therapies to improve overall patient outcomes. 

After seeing what Sentri7 could do for antimicrobial stewardship, Aultman Hospital has plans to use this powerful tool from Wolters Kluwer to focus next on opioid stewardship, diabetes management, sepsis readmissions, and chronic obstructive pulmonary disorder readmissions. 

Physician acceptance rate for antimicrobial stewardship interventions hit approximately 95%, demonstrating a high level of trust between the physicians and pharmacy. “In large part, that’s due to Sentri7 being in place,” said Matt Baldwin, PharmD. 

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