Creating Meaningful Meetings: A Rural Health Approach for Engagement in Antimicrobial Stewardship and Multidrug Resistant Organism Tracking

BACKGROUND In response to the Center for Disease Control and Prevention's (CDC) Antibiotic Resistance Threats Report in 2013, the National Strategy for Combating Antibiotic-Resistant Bacteria provided recommendations to decrease the burden of multi-drug resistant organisms (MDROs). These recommendations included support for antimicrobial stewardship (AMS) programs across settings as well as improved surveillance of MDROs. Our goal was to set up regional meetings to 1) engage healthcare providers from diverse, rural settings on AMS and infection prevention topics and provide a forum for collaboration; 2) encourage submission of carbapenem-resistant organisms (CROs) and antibiogram data to the state laboratory; 3) identify opportunities for goal-setting and allocation of state-level resources. METHODS A Quality Innovation Network-Quality Improvement Organization collaborated with three programs within the state Department of Health (Healthcare Associated Infection (HAI), Medicare Beneficiary Quality Improvement Program (MBQIP) and the Bureau of Laboratories) to hold a series of four face-to-face, cross-setting regional meetings. Meeting satisfaction was evaluated by a brief on-site survey. CRO sample and antibiogram submissions were tracked before and after the meetings. Meeting discussions were documented and grouped by topic. RESULTS Four regional meetings were completed between April-September, 2018 with 103 attendees representing 21 hospitals, 17 long-term care facilities and 6 ambulatory settings. Overall participant satisfaction was 4.35/5. The number of CRO isolates that were tested in our state laboratory increased by 200% and the number of organizations that agreed to submit antibiogram data increased from three to 10 (233% increase) following the events. Major areas of concern identified by participants were: 1) care transitions; 2) physician AMS education; 3) public education on MDRO risk and the role of AMS. CONCLUSIONS Regional meetings that uniquely align infection prevention, pharmacy and laboratory are a highly effective forum to promote cross-setting engagement and collaboration in a rural state with limited resources.