Acute Care and Critical Access Honor Roll: One Health Antibiotic Stewardship Collaborative

Minnesota Antibiotic Stewardship Acute Care and Critical Access Honor Roll: Minnesota Antibiotic Stewardship

Application Process

Application

Facilities may apply at any time. Updates to the Honor Roll will be made quarterly.

  • Minnesota Antibiotic Stewardship Honor Roll Invitation (PDF)
    The Minnesota Hospital Association, Stratis Health, the Association for Professionals in Infection Control, the Collaborative Healthcare-Associated Infection Network, and the Minnesota One Health Antibiotic Stewardship Collaborative invite hospital partners to apply for recognition on the Honor Roll.

Step 1: Collect your information

Step 2: Fill out the application

Step 3: Submit the required materials

2018 Renewal Process

  • Honor Roll membership will be renewable annually. The 2018 renewal process has not been released yet.

2017 and 2018 honorees are listed below.

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Gold Level

  • Gold Level hospitals are recognized for looking beyond their facility to practice antibiotic stewardship in a collaborative way.
    Collaborative activities are highlighted below.
  • Gold Level hospitals have also achieved Bronze and Silver Level requirements for commitment and action.

2018 Minnesota Antibiotic Stewardship Acute Care and Critical Access Hospital Gold Level Honor Roll Honorees

Avera Marshall Regional Medical Center

  • Physician Leader: Justin Hartman, DO
  • Pharmacist Leader: Rachelle Kunde, PharmD, BCACP
  • Additional Antibiotic Stewardship Action: Avera Marshall participates daily in a weekday video conference call that serves to connect Avera Health system-level physicians and pharmacists with pharmacists throughout the Avera system. Participants review patient cases together, helping local pharmacists assist providers in making antimicrobial treatment decisions.
  • Highlighted Collaborative Activity: Avera Marshall distributes CDC Get Smart patient education materials to local outpatient clinics, and provides long-term care facilities with nurse and provider education, resident and family education (e.g. family night, brochures), and pharmacist evaluation for antimicrobial appropriateness.

Essentia Health St. Mary's Detroit Lakes

    • Physician Leader: John Belk, DO
    • Pharmacist Leader: Nicholas Helbling, PharmD, BCPS
    • Other Leader:Jackie McKenzie, RN, BSN
    • Additional Antibiotic Stewardship Action: Essentia Health St. Mary’s Detroit Lakes Hospital requires indications for all antibiotic orders, and a pharmacist reviews all antibiotics daily. Medication use evaluation is conducted for specific broad-spectrum antibiotics.
    • Highlighted Collaborative Activity: Stewardship team members participate in the Local Collaborative for Antibiotic Stewardship Detroit Lakes, a pilot project supported by the Minnesota Department of Health. The collaborative membership includes acute care, long term care, and ambulatory care representatives from Sanford, Essentia, and Ecumen health systems. Goals of the collaborative include enhancing communication among facilities sharing patient populations, improving antibiotic stewardship within individual facilities and across care transitions, and engaging patients, families, and the public in antibiotic stewardship concepts and actions.

2017 Minnesota Antibiotic Stewardship Acute Care and Critical Access Hospital Gold Level Honor Roll Honorees

Abbott Northwestern Hospital *

  • Physician Leader: Dan Anderson, MD
  • Pharmacist Leaders: Jessica Holt, PharmD, BCPS-AQ ID and Krista Gens, PharmD, BCPS-AQ ID
  • Additional Antibiotic Stewardship Action: All patients receiving anti-infectives, who are not followed by an ID provider, are reviewed Monday-Friday daily by 2 ID-trained pharmacists.  Clinical pharmacists review in real-time all positive blood cultures and intervene as needed. An Allina-wide treatment algorithm guides pharmacists and providers.
  • Highlighted Collaborative Activity: Abbott Antibiotic Stewardship Program also provides remote services to 4 regional hospitals within Allina Health (New Ulm, Owatonna, District One, and River Falls), reviewing patients Monday, Wednesday, and Friday remotely, and maintaining weekday availability for questions. A joint quarterly stewardship report is developed for those sites.

Bigfork Valley Hospital

  • Physician Leader: Eric Scrivner, MD
  • Pharmacist Leader: Sara Elioff, PharmD, RPh
  • Additional Antibiotic Stewardship Action: Implemented clinical indication requirement for all new anti-infective orders, which has improved communication and facilitated prescribing appropriateness assessments. Data are presented quarterly at Pharmacy & Therapeutic Committee meetings for parenteral ceftriaxone, levofloxacin, and piperacillin/tazobactam.
  • Highlighted Collaborative Activity: Work closely with other rural Minnesota Critical Access Hospitals serviced by Bigfork Valley Hospital’s after-hours pharmacy provider. Pharmacy leaders discuss each facility’s antibiotic stewardship initiatives and share ideas and tools (e.g., DOT and Clinical Indication Tracker developed by Bigfork Valley’s pharmacist leader).

CentraCare Health-Paynesville

  • Physician Leader: Randy Nelson, MD
  • Pharmacist Leader: Kaitlyn Latour, PharmD
  • Additional Antibiotic Stewardship Action: Developed and implemented several disease-specific order sets to encourage appropriate antibiotic use in inpatient and outpatient settings.
  • Highlighted Collaborative Activity: The hospital pharmacy team also covers the clinic and nursing home. Nursing home staff and pharmacy staff collaborate to ensure that every antibiotic prescription has a stop date and appropriate dosing based upon indication, renal function, and patient allergies.  The nursing home has updated guidelines for appropriate UTI treatment, including symptom monitoring and urine collection methodology.

CentraCare Health—Sauk Centre

  • Physician Leader: Mari Thomas, MD
  • Pharmacist Leader: Dennis Heinen
  • Additional Antibiotic Stewardship Action: Developed antimicrobial stewardship program in the hospital’s Information System to monitor for drug-bug mismatches, drug-lab mismatches, and duplicate therapies.
  • Highlighted Collaborative Activity: Hospital stewardship team works with the nursing home to improve antibiotic stewardship for urinary tract infections and to monitor use of vancomycin in nursing home residents.

Children's Minnesota

  • Physician Leader: William Pomputius, MD
  • Pharmacist Leader: Steve Grapentine, PharmD, BCPS
  • Additional Antibiotic Stewardship Action: Implemented prescription-centric actions, including a 72 hour “antibiotic stop rule” for select broad spectrum antibiotics, indication requirement in pharmacy orders, and restriction of some antibiotics to infectious disease physician use.
  • Highlighted Collaborative Activity: Collaborated with Allina Health to develop the 2017 Allina Health and Children’s Minnesota Joint Pediatric Outpatient & ED Antibiotic Reference Guide For Children ≥ 2 months old. The reference provides guidance for 1st–3rd line antibiotics, including dose, frequency, and duration. The guideline is in use in Children’s Minneapolis and St. Paul ambulatory clinics, with future expansion to 12 affiliated primary care pediatric clinics.

FirstLight Health System, Mora MN

  • Physician Leader: Brian Niskanen, MD and Matthew Allen, MD
  • Pharmacist Leader: Nicholas Giller PharmD, BCPS, BCOP
  • Other Leader: Cindy Teichroew, BSN, RN, CIC
  • Additional Antibiotic Stewardship Action: Pharmacists evaluate appropriateness of antibiotic use in real-time for all inpatient, emergency department, and urgency service antibiotics.
  • Highlighted Collaborative Activity: Pharmacists and prescribing staff optimize antibiotic stewardship during care transitions. All inpatients receiving antibiotics at hospital discharge receive a pharmacist or nurse follow-up phone call within 72 hours or receive a comprehensive medication therapy management (MTM) visit from an MTM pharmacist.  All at-home antibiotics prescribed at hospital discharge are evaluated by a pharmacist for appropriateness using the “5 D's”. 

Gillette Children's Specialty Healthcare

  • Physician Leaders: Ralph Faville, MD and Emily Schaaf, MD
  • Pharmacist Leaders: Kristen Chisholm, Johnson Innis, and Fan Zhang
  • Other Leader: Tina Schlottman RN, BSN
  • Additional Antibiotic Stewardship Action: Three times per week, pharmacist, infection prevention nurse, and ID physician meet for 30 minutes and discuss all inpatient antibiotics, including dose, frequency, duration, and cultures to ensure patients are on the correct antibiotic.
  • Highlighted Collaborative Activity: Gillette is part of the regional Children's Hospitals' Solutions for Patient Safety Collaborative, focused on reducing harm by practicing antibiotic stewardship and preventing readmissions, serious safety events, and eleven specific hospital acquired conditions, including C. difficile.

Glacial Ridge Health System

  • Physician Leader: Roderick Brown, MD
  • Pharmacist Leader: Grace Hillesheim, PharmD
  • Other Leader: Jeanette Pasche, RN, CIC
  • Additional Antibiotic Stewardship Action: Use NHSN for C. difficile tracking and MRSA bloodstream infections to evaluate impact of hospital stewardship interventions.
  • Highlighted Collaborative Activity: Participate in the Minnesota-Ohio Hospital Association Healthcare Improvement Innovation Network Antibiotic Stewardship/MDRO Collaborative.

Hennepin County Medical Center  *

  • Physician Leader: Rebecca Zadroga, MD
  • Pharmacist Leader: Aileen Ahiskali, PharmD
  • Additional Antibiotic Stewardship Action: Implemented antibiotic drug restriction for expensive, broad spectrum, and high risk antibiotics (e.g., tigecycline, isavuconazole, fosfomycin, oritavancin). These drugs can only be administered with infectious disease physician approval. The goal of restriction is to preserve organism susceptibility, minimize patient side-effect risk, and/or curb hospital costs.
  • Highlighted Collaborative Activity: Participate in a Minnesota Hospital Association collaborative focused on sharing outcomes data and ideas to improve antibiotic stewardship statewide. Monthly phone calls involve open discussion among hospitals about struggles and successes in stewardship and prevention of healthcare-associated infections.

Lakeview Hospital

  • Physician Leader: Alison Wing, MD
  • Pharmacist Leader: Cindy Appleseth
  • Other Leader: Patty Willeman
  • Additional Antibiotic Stewardship Action: Over 3,000 order sets have been updated to include a required field for antibiotic use indication.
  • Highlighted Collaborative Activity: Partnered with pharmacies across HealthPartners to update over 3,000 order sets to require an indication for all antibiotics prescribed in the hospital setting.

Park Nicollet Methodist Hospital *

  • Physician Leader: Sadia Ali, MD
  • Pharmacist Leaders: Galina Shteyman, PharmD and Kelly Becicka, PharmD
  • Additional Antibiotic Stewardship Action: Emergency Center Pharmacist Collaborative Practice Agreement is in place to support antibiotic stewardship and treatment decisions.
  • Highlighted Collaborative Activity: Through the Multi-hospital AMS Committee, antibiotic use and resistance data are shared with six enterprise hospitals. Emergency Center pharmacists follow up on all late culture results, optimizing therapy based on the collaborative practice agreement.

Regions Hospital

  • Physician Leader: Becca Peglow, MD
  • Pharmacist Leader: Mary Ullman
  • Additional Antibiotic Stewardship Action: Restricted antimicrobial list used to save last line agents for difficult to treat infections. All patients started on an antimicrobial receive specific counseling from RN about indication, side effects, and importance of completing prescription as prescribed.
  • Highlighted Collaborative Activity: Worked with four other hospitals to develop standard patient education resources for hospitals and hospital-associated clinics.

Rice Memorial Hospital

  • Physician Leader: Lucio Minces, MD
  • Pharmacist Leader: Nathan Goracke, PharmD
  • Additional Antibiotic Stewardship Action:  Daily antibiotic-use reports are reviewed by a clinical pharmacist for appropriateness, renal dosing, intravenous-to-oral transition, de-escalation, and other necessary interventions.
  • Highlighted Collaborative Activity: Rice Memorial hospital shares their antibiogram and infectious disease expertise. The yearly antibiogram is provided to over ten facilities by the hospital’s outreach laboratory for use in their stewardship practices. The infectious disease physician mentors and facilitates stewardship practices in four area facilities.

Sanford Medical Center Thief River Falls

  • Physician Leader: Ashok Patel, MD
  • Pharmacist Leader: Donna Harlow, PharmD
  • Other Leader: Carla Szklarski
  • Additional Antibiotic Stewardship Action: An assessment (“time-out”) is conducted at morning huddle for patients on antibiotics 48-72 hours after first administration.
  • Highlighted Collaborative Activity: In 2017, the stewardship team was invited to attend a CDC-Pew Charitable Trusts meeting in Atlanta, Georgia. With representatives of other facilities, Sanford Thief River Falls discussed challenges and approaches to meeting antibiotic stewardship requirements and informed the development of specific guidance materials for critical access hospitals. The hospital team has also partnered with area skilled nursing and assisted living facilities to provide education and materials for improvement of UTI management.

University of Minnesota Medical Center * **

  • Physician Leader: Susan Kline, MD, MPH
  • Pharmacist Leader: Kimberly Boeser, PharmD., MPH, BCPS AQ-ID
  • Additional Antibiotic Stewardship Action: The antibiotic stewardship team is on-call (8a-10p, 7d/week) for all blood cultures positive for Gram-negative bacteremia. A treatment algorithm, created with antibiogram data, is used to evaluate appropriateness of Gram-negative antibiotic therapy, ensure the patient is on treatment, or to rapidly narrow broad-spectrum therapy.
  • Highlighted Collaborative Activity: UMMC mentors other Fairview hospitals, and the home infusion  team, to implement similar stewardship programs at their sites. UMMC trains post-graduate year 2 Infectious Disease Pharmacy Residents, contributing to the availability of the CDC Antibiotic Stewardship Core Element, "Drug Expertise". Residents complete three required Antimicrobial Management Team rotations, one Antibiotic Stewardship Leadership rotation, two stewardship community engagement projects, and conduct a year-long stewardship research project.

* This hospital has a Minnesota One Health Antibiotic Stewardship Collaborative work group member.
** This facility utilizes the NHSN Antibiotic Use and Antibiotic Resistance Module.

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Silver Level

  • Silver hospitals practice the following antibiotic stewardship actions:
    • Days of Therapy (DOT)-based antibiotic use tracking.
    • DOT reporting to the antibiotic stewardship team.
    • Antibiogram use (for hospitals with on-site diagnostic laboratory).
    • Patient, family, and public education about antibiotic use.
    • At least one additional antibiotic stewardship intervention.
      Intervention actions are highlighted below.
  • Silver Level hospitals have also achieved Bronze Level requirements for commitment.

2018 Minnesota Antibiotic Stewardship Acute Care and Critical Access Hospital Silver Level Honor Roll Honorees

Cuyuna Regional Medical Center

  • Physician Leader: Abby Murray, MD
  • Pharmacist Leader: Justin Richards, PharmD
  • Additional Antibiotic Stewardship Action: Cuyuna Regional Medical Center uses a pharmacist-driven extended-infusion piperacillin/tazobactam procedure. Providers and pharmacy staff review antimicrobials daily for discussion at bedside rounds. Pharmacy staff provide pharmacokinetic monitoring/dosing and utilize a renal dosing policy.

Fairview Ridges Hospital

  • Physician Leader: Steven Dittes, MD
  • Pharmacist Leader: Ronald Greenberg, PharmD, BCPS
  • Additional Antibiotic Stewardship Action: The Fairview Ridges antibiotic stewardship pharmacist and infectious disease physician meet twice weekly to review restricted antibiotic prescriptions. Antibiotic stewardship recommendations are made to the physician by clinical note in the medical record.

Lake Region Healthcare

  • Physician Leader: Joshua Overgaard
  • Pharmacist Leader: Kayla Duberowski
  • Other Leaders: Terri Anderson, Infection Prevention Coordinator and Abby Drouillard, Quality and Patient Experience Director
  • Additional Antibiotic Stewardship Action: Lake Region Healthcare tracks facility-wide antibiotic prescribing for bronchitis diagnoses. Providers are given blinded individual reports, and overall reports are shared with the Antibiotic Stewardship and Outpatient Committees.

2017 Minnesota Antibiotic Stewardship Acute Care and Critical Access Hospital Silver Level Honor Roll Honorees

CHI St. Joseph's Health, Park Rapids

  • Physician Leader: Nathan Harris, MD
  • Pharmacist Leader: Jodi Behrens, PharmD
  • Other Leader: Wendy Gullicksrud, BSN, RN, CIC
  • Additional Antibiotic Stewardship Action: Reviewed and improved the process for C. difficile management, including IPC actions, staff training, and prescribing guidelines.

CHI St. Joseph's Health, Park Rapids

  • Physician Leader: Nathan Harris, MD
  • Pharmacist Leader: Jodi Behrens, PharmD
  • Other Leader: Wendy Gullicksrud, BSN, RN, CIC
  • Additional Antibiotic Stewardship Action: Reviewed and improved the process for C. difficile management, including IPC actions, staff training, and prescribing guidelines.

Fairview Southdale Hospital 

  • Physician Leader: Steven Dittes, MD
  • Pharmacist Leader: Emily Medcraft, PharmD, BCPS
  • Additional Antibiotic Stewardship Action: Antimicrobial Stewardship Pharmacist is involved with order set and guideline review and development, ensuring use of anti-infective evidence-based protocols.

Olmsted Medical Center

  • Physician Leader: Paulo Guimaraes, MD
  • Pharmacist Leader: Anna Baldwin
  • Additional Antibiotic Stewardship Action: Penicillin allergy stewardship program.

United Hospital  *

  • Physician Leaders: Ayesha Rashid, MD and Gary Kravitz, MD
  • Pharmacist Leader: Deb Klein
  • Other Leader: Kelsey Wick
  • Additional Antibiotic Stewardship Action: Pharmacist-level interventions are in place, including use of indication tabs for all antibiotic orders, automatic alerts for duplicative therapy and antibiotic-related drug-drug interactions, restriction of some antibiotics to infectious disease physician use.

* This hospital has a Minnesota One Health Antibiotic Stewardship Collaborative work group member.

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Bronze Level

  • Bronze Level hospitals have demonstrated facility-wide commitment to antibiotic stewardship by submitting:
    • Antibiotic stewardship policy or similar document.
    • Commitment letter from the facility CEO/COO or other relevant executive.
    • Names of the stewardship leaders.
    • Description of staff and clinical caregiver antibiotic stewardship education activities.

2018 Minnesota Antibiotic Stewardship Acute Care and Critical Access Hospital Bronze Level Honor Roll Honorees

Fairview Northland Medical Center

  • Physician Leader: James Katter, MD
  • Pharmacist Leader: Mark Schindlbeck
  • Other Leader: Paul Loven, Infection Preventionist

Renville County Hospital

  • Physician Leader: Kelsey Fisher, NP
  • Pharmacist Leader: Kjersha Naber

Tri-County Health Care

  • Physician Leader: Greg Smith, MD
  • Pharmacist Leader: Michelle Hinojos, PharmD
  • Other Leader: Cheryl Houselog, MT (ASCP)

2017 Minnesota Antibiotic Stewardship Acute Care and Critical Access Hospital Bronze Level Honor Roll Honorees

Fairview Lakes Medical Center

  • Physician Leader: David Milbrandt, MD
  • Pharmacist Leader: Jennifer Johnson, PharmD

Fairview Range Medical Center

  • Physician Leader: Tony Bastianelli, DO
  • Pharmacist Leader: Sara Madden, PharmD, MBA
  • Other Leader: Lisa Hesse, MLS CIC

HealthEast *

  • Physician Leader: Jason Wirtz, MD
  • Pharmacist Leader: Sherri Jobin, PharmD, BCPS
  • Other Leader: Mindy D. McFarren, MS, MT(ASCP), CIC

Lakewood Health System

  • Physician Leader: John Halfen, MD  
  • Pharmacist Leader: Nicole Nelson, PharmD, BCPS

LifeCare Medical Center

  • Physician Leader: Chibuike Anokwute
  • Pharmacist Leader: Gordon Streiff, PharmD
  • Other Leader: Jane Hirst, RN

Meeker Memorial Hospital

  • Physician Leader: Debra Peterson, Lucio Minces       
  • Pharmacist Leader: Kelly Larson

Mille Lacs Health System

  • Physician Leader: Ranjita Adhikari, MD
  • Pharmacist Leader: Mo Hussan
  • Other leader: Vicki Engmark, BS, RRT, CIC

* This hospital has a Minnesota One Health Antibiotic Stewardship Collaborative work group member.

The Minnesota Antibiotic Stewardship Acute Care and Critical Access Honor Roll is supported by the Minnesota department of Health, Minnesota Hospital Association, Stratis Health, Association for Professionals in Infection Control, and promoted on behalf of the Collaborative Healthcare-Associated Infection Network.

Updated Friday, 08-Jun-2018 13:49:43 CDT