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An Industry Perspective: Effective Antibiotic Stewardship in Urgent Care Is Achievable

Posted on by CDC's Safe Healthcare Blog
J.D. Zipkin, MD, MA, Associate Medical Director at Northwell Health-GoHealth Urgent Care
J.D. Zipkin, MD, MA

There is room for improvement in antibiotic prescribing in the urgent care setting, as demonstrated by a recently published research letter by the CDC. The data showed outpatient antibiotic prescription rates for antibiotic-inappropriate conditions are highest in urgent care centers as compared to retail clinics, emergency departments, and medical offices.

As a clinician working in urgent care, I know firsthand of the unique pressures faced by urgent care providers on the front lines, such as the higher volume of encounters that may appropriately require antibiotics, lack of established patient-provider relationships, and value by organizational leadership placed on patient satisfaction. However, as we have seen at the more than 95 GoHealth Urgent Care centers across the country, effective antibiotic stewardship in urgent care is not only possible, but it can also be done without negatively impacting patient satisfaction.

From inception, GoHealth Urgent Care and our leading health system partners have prioritized antibiotic stewardship. At Northwell Health-GoHealth Urgent Care in New York, for example, this is evident in our provider hiring, orientation education, ongoing training, and monthly chart audits. Our provider feedback cites professional society guidelines, such as those from the Infectious Diseases Society of America (IDSA), to improve evidence-based practices. As a result, our rate of inappropriate antibiotic prescribing is substantially below the urgent care national average, and our goal is to reduce it even further. Even with an intense focus on antibiotic stewardship, we have achieved industry-leading patient satisfaction scores, and our internal analytics have shown no direct correlation between antibiotic prescribing and patient satisfaction. This reinforces that our success has always been achieved through quality, evidence-based medicine and that high patient satisfaction can be achieved if the right level of education and support is provided.

Cohen Children’s/Northwell Health-GoHealth Urgent Care center in Hewlett, New York.
Cohen Children’s/Northwell Health-GoHealth Urgent Care Center in Hewlett, New York.

As we recognize U.S. Antibiotic Awareness Week (November 12-18, 2018) this week, we have another timely reason to reignite the discussion on this important topic. We encourage our urgent care colleagues to examine their antibiotic prescribing practices for opportunities for improvement. Additionally, we see immense value in expanding collaboration among urgent care organizations to bring greater awareness and action around antibiotic stewardship. We are already working to improve industry resources, aligning with the CDC, and working with other partners such as George Washington University’s Antibiotic Resistance Action Center (ARAC). We look forward to sharing our strategies with our community to improve antibiotic prescribing so that we can protect future generations against antibiotic resistance.

Dr. Jonathan Zipkin is the associate medical director and regional medical informatics officer for Northwell Health-GoHealth Urgent Care, responsible for clinical leadership across its New York City-based urgent care centers. He also serves as the regional medical informatics officer for the New York market and serves as the chair of GoHealth Urgent Care’s national clinical steering subcommittee on quality. He has a passion for systems analysis and antibiotic stewardship to increase responsible antibiotic use in the urgent care setting. He is board-certified in pediatrics and internal medicine. Dr. Zipkin can be found on Twitter @ZipkinMD.

Posted on by CDC's Safe Healthcare Blog

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