Tuesday, March 29, 2016

Curtailing Unnecessary antibiotic Use and the Peer to Peer Comparison

It is estimated that nearly 50% of all outpatient antibiotics are unnecessarily prescribed. This recent article in the Sunday New York Times Sunday Review explores mechanisms in which antibiotic prescription can be curtailed. One study highlighted in the article employed a peer-to-peer comparison of antibiotic prescribing practices across primary care providers.

When compared to peers, physicians categorized as 'poor performers' tend to improve their practice, in this case with respect to antibiotic prescribing.

I have learned that the peer-to-peer comparison is a powerful tool for driving behavior change an improving best practices in infection prevention. Surgeon-to-surgeon comparison of surgical site infection outcomes heightens attention to risk reduction interventions. Comparisons between units and wards are also powerful, particularly when it comes to adherence with best practices such as hand hygiene, head of bed elevation, chlorhexidine bathing, central line insertion checklist completion and daily review with documentation of ongoing urinary catheter need.

Physicians and nurses, particularly those in leadership, tend to be high achievers. Use it as an advantage. No one provider or hospital unit wants to be the outlier in poor performance.