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Antibiotic Stewardship Program

Critical Access Hospitals (CAHs) Antibiotic Stewardship Programs are required by the Federal Office of Rural Health Policy and are part of your eligibility for receiving Medicare Rural Hospital Flexibility (Flex) funded activities along with a Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoP) ruling. As of September 2019 (this rule was originally proposed in June 2016), CAHs were given six months to develop and implement their programs. The CoP rule 482.42 and 485.640 is still in place. Our team at the University of North Dakota Center for Rural Health Flex Program has been tasked with providing technical assistance in the development and implementation of Antibiotic Stewardship Programs throughout the state.

Project Participation Requirements

  • Complete the online assessment tool at the onset, at four months, and upon completion of the project
  • Peer Exchange
  • Project Evaluation
    • This evaluation is anonymous feedback that will be needed at least twice during the duration of the project. It will take one to three minutes to complete the evaluation survey.
  • Utilize the Antibiotic Stewardship Project SharePoint site for uploading the project tracker
  • Follow up with Flex Program on each phase of your project: Plan, Do, Study, Act
  • Consider presenting your project efforts and results during the next Flex Program Conference

Summary of Core Elements

  1. Leadership Commitment: Dedicating necessary human, financial, and information technology resources.
  2. Accountability: Appointing a single leader responsible for program outcomes. Experience with successful programs show that a physician leader is effective.
  3. Drug Expertise: Appointing a single pharmacist leader responsible for working to improve antibiotic use.
  4. Action: Implementing at least one recommended action, such as systemic evaluation of ongoing treatment needs after a set period of initial treatment. For example, have an “antibiotic time out” after 48 hours.
  5. Tracking: Monitoring antibiotic prescribing and resistance patterns.
  6. Reporting: Regular reporting information on antibiotic use and resistance to doctors, nurses, and relevant staff.
  7. Education: Educating clinicians about resistance and optimal prescribing.