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Poster Commitments Make an Impact on Antibiotic Prescribing

Posted on by CDC's Safe Healthcare Blog

Author: Katherine Fleming-Dutra

A commitment from all healthcare team members to prescribe antibiotics appropriately and engage in antibiotic stewardship is critical to improving antibiotic prescribing. Clinicians can demonstrate commitment to appropriate antibiotic prescribing by writing and displaying public commitments in support of antibiotic stewardship. For example, inappropriate antibiotic prescriptions for acute respiratory infections were reduced after clinicians displayed, in their examination rooms, a poster showing a letter from the clinician to their patients committing to prescribing antibiotics appropriately1.

Displaying a personalized commitment poster is a promising, low cost quality improvement intervention that can be used to improve patient satisfaction. The study indicates there is greater provider “buy-in” to the concept when their professional reputation is on the line. The study’s authors, including Drs. Daniella Meeker, Jeffrey Linder, and Jason Doctor, have assisted states and clinicians across the country to implement their own versions of this commitment to appropriate antibiotic prescribing.

Samples from Illinois campaign, Precious Drugs & Scary Bugs

The Illinois Department of Public Health (IDPH) launched the statewide campaign, Precious Drugs & Scary Bugs, in March 2015 to promote appropriate antibiotic prescribing in outpatient settings. The campaign targeted outpatient providers in primary care, urgent care, and community health centers. Among other activities, these providers were asked to display a poster-sized letter to the patient, personalized with providers’ names and photographs, stating the providers’ commitment to appropriate antibiotic prescribing for acute respiratory infections. To facilitate provider engagement and help standardize poster roll-out at facilities, IDPH developed an implementation guide that describes campaign activities and provides implementation tip sheets, email templates for communicating with providers, and select patient/provider resources. IDPH also developed a campaign website including archived presentations and other resources. outpatient practices signed up to participate in the campaign, representing 389 providers, and more than 600 commitment posters were printed and distributed.

In Texas, Superior HealthPlan collaborated with Texas Health and Human Services Commission and Department of State Health Services, as well as Drs. Meeker, Linder and Doctor, to develop a provider commitment poster. In addition to distributing the posters to hundreds of providers in Superior’s network, an electronic version will be made available for providers to download from Superior’s website. The poster distribution is part of a strategic outreach effort to encourage providers to treat illnesses in the best possible way and avoid prescribing antibiotics when they are likely to do more harm than good. 

NYS Department of Health recently rolled out a “Get Smart Guarantee” poster
The NYS Department of Health recently rolled out a “Get Smart Guarantee” poster for healthcare providers to pledge to only prescribe antibiotics when they are needed.

In New York State, the NYS Department of Health recently rolled out a “Get Smart Guarantee” poster for healthcare providers to pledge to only prescribe antibiotics when they are needed. The “Guarantee” poster can be personalized with the provider’s photo and signature. An accompanying “Get Smart Guarantee” patient “palm card” was also developed, as a means of educating patients about antibiotic resistance. Some providers indicate patients often expect antibiotics even if the illness is viral, where antibiotics would not be effective. This card is a “takeaway” for patients in lieu of a prescription for antibiotics. Ideally, they will feel their concerns have been heard and validated. The poster and palm card will be offered in English/Spanish language.

1Meeker D, Knight TK, Friedberg MW, et al. Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial. JAMA Intern Med 2014;174:425–31. http://dx.doi.org/10.1001/jamainternmed.2013.14191 PubMed

Posted on by CDC's Safe Healthcare Blog

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