Overuse of antibiotics accelerates the emergence of resistance and puts patients at risk. Still, 1 in 3 antibiotics prescribed in doctors’ offices, emergency rooms, and other outpatient settings in the United States are unnecessary.
This inappropriate antibiotic prescribing varies by type of health care facility. According to one study that looked at urgent care centers, nearly half of patients diagnosed with common conditions such as asthma, bronchitis, and the common cold—for which antibiotics are neither recommended nor effective—receive an antibiotic prescription anyway.
Health care facilities are working to combat resistant infections and improve patient outcomes through implementation of antibiotic stewardship programs. One organization making significant strides is Intermountain Healthcare, a health system based in Salt Lake City that includes 24 hospitals, over 180 office practices, home care, and telehealth.
Dr. Eddie Stenehjem serves as antibiotic stewardship medical director for Intermountain Healthcare. As part of the system’s effort, Stenehjem and his team created posters communicating the organization’s commitment to providing the best care possible, including the importance of using antibiotics only when they benefit the patient. The posters are displayed outside urgent care clinics and inside patient rooms. Research shows that such public commitments help to improve antibiotic use because they keep the pledge easily visible to doctors and patients.
Intermountain urgent care doctors can access a dashboard tool that displays their antibiotic prescribing rates for acute respiratory conditions as well as the prescribing rates of other doctors and clinics throughout the system. Studies show that such peer comparisons can motivate physicians to change prescribing behaviors.
Dr. Park Willis, the urgent care system’s lowest antibiotic prescriber, regularly speaks to other Intermountain Healthcare colleagues about how to use the dashboard and what strategies work best when talking to patients about antibiotics. These conversations help keep the issues surrounding overuse of antibiotics front and center and encourages others to take advantage of the system’s available tools.
Similarly, Stenehjem, as antibiotic stewardship medical director, routinely talks to doctors and patients about what they need. Intermountain’s stewardship team used this approach to design a program—launched in the summer of 2019—tailored to the urgent care community it serves. The system is already seeing positive results in improved antibiotic prescribing.
All photos used with permission from Intermountain Healthcare