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

Application process

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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

Renewal Process

  • Honor Roll membership will be renewable annually. Renewal applications will be sent out one year after the initial online application was completed.
  • Renewal applications contain the responses from the initial application. Those renewing will review the initial information for accuracy and add all renewal application information on the same form.
    NOTE: Applicants are now able to upload their letters of commitment and antibiotic stewardship policies directly into their application.

2022 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.

2022 Minnesota Antibiotic Stewardship Acute Care and Critical Access Gold Level Honor Roll Honorees

  • Physician Leaders: Dan Anderson, MD and Steve Sonnesyn, MD
  • Pharmacist Leaders: Mike Wankum PharmD, BCPS, BCIDP and Krista Gens, PharmD, BCPS, BCIDP, DPLA
  • Highlighted Antibiotic Stewardship Activity:
    Abbott Northwestern Hospital has piloted an antibiotic stewardship program in the home hospital setting, and pharmacists review records for patients discharging on IV antibiotics to ensure appropriate care.
  • Collaboration:
    The Abbott Northwestern Hospital stewardship program provides best practice education, prospective audit with feedback, and stewardship data coordination to multiple critical access hospitals.
  • Physician Leader: Eric Scrivner, MD
  • Pharmacist Leader: Sara Elioff, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    The Bigfork Valley Hospital team created an electronic medical record report, "Prescriber Antibiotic Stewardship Performance Report," that details patient, drug, frequency, stop/start dates, clinical indication, and ordering provider. This report is reviewed by the stewardship program and shared with prescribers. It can be used to identify opportunities for improvement in prescribing practices.
  • Collaboration:
    Bigfork Valley Hospital works closely with other rural Minnesota critical access hospitals serviced by the same after-hours pharmacy provider. Together, this group of pharmacy leaders learns about stewardship initiatives at each facility. Through this collaboration, initiatives (e.g., Bigfork Valley Hospital's days of therapy tracker) may be adopted by other sites.
  • Physician Leader: Ulrika Wigert, MD
  • Pharmacist Leader: Dennis Heinen, RPh
  • Highlighted Antibiotic Stewardship Activity:
    The CentraCare - Sauk Centre stewardship team utilizes prospective audit with feedback as an intervention to optimize antibiotic therapy and to educate providers.
  • Collaboration:
    CentraCare - Sauk Centre collaborates with other hospitals in the region to develop and discuss protocols for antimicrobial therapies and changes needed to those protocols. The hospital also collaborates in development of a regional antibiogram. The antibiogram is shared with six CentraCare hospitals and is used to create appropriate order protocols for the system. The antibiogram is available for providers and pharmacist on patient-specific case issues.
  • Physician Leader: John Hering, MD
  • Pharmacist Leader: Kaitlyn Stenberg, PharmD, BCPS
  • Highlighted Antibiotic Stewardship Activity:
    CentraCare Health Monticello reports both antibiotic administration and antimicrobial resistance data to CDC through the National Healthcare Safety Network Antimicrobial Use and Resistance Module.
  • Collaboration:
    CentraCare Health Monticello works in collaboration with all of the other CentraCare and Carris Health sites on antimicrobial stewardship, meeting on a quarterly basis to review best practices, order sets, and education. CentraCare Monticello collaborates with the Monticello Care Center to dose and monitor vancomycin for long-term care residents, and participate in other antimicrobial stewardship and infection prevention activities.
  • Physician Leader: Laura Fier, MD
  • Pharmacist Leader: Justin Richards, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    The Cuyuna Regional Medical Center antimicrobial stewardship team communicates antibiotic use data to hospital leadership, the pharmacy and therapeutics committee, the quality assurance and performance improvement team, and the infection prevention team through in-person meetings and a data dashboard.
  • Collaboration:
    Cuyuna Regional Medical Center has formed an antimicrobial stewardship collaborative between inpatient, clinic, and long-term care facilities. The collaborative has worked to optimize antibiotic stewardship during care transitions.
  • Physician Leaders: Sandra Martsching, MD and Angela Skyberg, PA
  • Pharmacist Leader: Janna Engel, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Essentia Health Ada uses guidelines to guide treatment of pediatric sinusitis, pediatric acute otitis media, pediatric lower respiratory tract infection, pediatric upper respiratory infection, pediatric Streptococcus infection, Lyme disease, anaplasmosis, and ehrlichiosis.
  • Collaboration:
    Essentia Health Ada works collaboratively with St. Joseph's Medical Center in Brainerd, MN, sharing protocols and data to help ensure best practices and a consistent patient experience. Both pharmacies review medication documentation, and meet monthly to discuss relevant updates to standards of practice.
  • Physician Leader: Jared Lund, MD
  • Pharmacist Leader: Sarah Litchke, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    At Essentia Health Deer River, antibiotic use is monitored by using the electronic medical record to explore specific drug groupings. Special attention is paid to the top ten most frequently prescribed agents. Data are used to evaluate prescribing trends within a department or by individual prescriber, inform agent-specific initiatives within the facility, and to identify and address outlying prescribing within a facility, department, or discipline.
  • Collaboration:
    Essentia Health Deer River collaborates with other hospitals to ensure documentation and communication of culture results to promote appropriate antibiotic prescribing. They also collaborate with the Indian Health Service on outpatient antimicrobial infusions and monoclonal antibody use to meet ongoing needs. Essentia Health Deer River works collaboratively with Thrifty White Pharmacy to ensure appropriate antimicrobial use in long-term care facilities.
  • Physician Leader: Cheryl White, MD
  • Pharmacist Leader: Ryan Laposky, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Essentia Health Fosston utilizes a dashboard to report antibiotic use data to the pharmacy and therapeutics committee, hospital leadership, the quality assurance and performance improvement team, prescribers, stewardship advisory committee, infection prevention team, and infectious diseases department.
  • Collaboration:
    Essentia Health Fosston collaborates with First Care Living Center, a nursing home that utilizes antibiotic tracking software as part of its antibiotic stewardship program.
  • Physician Leader: Jessica Kleindl, MD
  • Pharmacist Leader: Kassandra Grimes, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    As part of their antibiotic stewardship and infection prevention initiatives, Essentia Health Graceville/Holy Trinity Hospital tracks patient outcomes including Clostridioides difficile infections and the antibiotic resistance patterns of bacteria causing clinical infection.
  • Collaboration:
    The hospital continues to work with local a nursing home to implement 48-hour antibiotic time out, for which an Essentia Health provider is called upon to review each case via the electronic medical record.
  • Physician Leader: Thomas Witt, MD
  • Pharmacist Leader: Robert Johnson, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Essentia Health Moose Lake uses days of therapy data to evaluate overall prescribing trends, inform agent-specific initiatives, and identify and address outlying prescribing within a prescribing location or discipline.
  • Collaboration:
    The antibiotic stewardship program manager attends quarterly medical staff meetings to speak on antibiotic stewardship efforts throughout the facility with prescribers, including both Essentia and non-Essentia providers invited from non-affiliated clinics.
  • Physician Leader: Christopher Whiting, MD
  • Pharmacist Leader: Peter Mattson, RPh
  • Highlighted Antibiotic Stewardship Activity:
    Essentia Health Northern Pines reports antimicrobial administration data to CDC through the National Healthcare Safety Network AU Option. These data are used by CDC and Minnesota Department of Health to track use for hospitalized patients. Hospitals use the Standardized Antimicrobial Administration Ratio to compare prescribing to that of similar hospitals.
  • Collaboration:
    The Essentia Health Northern Pines pharmacy offers formal consultative services to the local long-term care facility and provides recommendations to optimize antimicrobial therapy. Orders for antimicrobials are reviewed for appropriate dose, duration, and indication using current Essentia Health antimicrobial treatment guidelines and antibiograms.
  • Physician Leader: Thomas Witt, MD
  • Pharmacist Leader: Eric Gangl, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Essentia Health Sandstone has a diverse antibiotic stewardship committee, including experts in medicine, pharmacy and infection prevention, and representation from the microbiology laboratory, nursing staff, information technology, quality improvement, patient safety, and hospital administration.
  • Collaboration:
    Essentia Health Sandstone participated in a collaborative AHRQ Safety Project for Antibiotic Stewardship. Subsequently, Essentia Health Sandstone incorporated new information on bacteremia, C. difficile, cellulitis, skin and soft tissue infections, asymptomatic bacteriuria and urinary tract infections, hospital-acquired pneumonia, community-acquired lower respiratory tract conditions into their provider education.
  • Physician Leader: Peter Henry, MD
  • Pharmacist Leader: Sarah Patton, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Clinical pharmacists at Essentia Health St. Joseph's Medical Center review patients daily to ensure appropriateness of antibiotic therapies based on an antimicrobial stewardship "score" assigned by the electronic medical record (EMR). This review includes an assessment of prescribed antibiotics, duration of therapy, culture results, and opportunities for de-escalation. Findings are documented in the EMR and providers are contacted as needed for follow up.
  • Collaboration:
    Recent collaboration with other facilities has primarily focused on COVID-19 therapeutics and resources, including sharing monoclonal antibody agents and COVID-19 vaccine with surrounding sites to ensure timely care of patients. In addition to this ongoing communication with healthcare facilities, Essentia Health St. Joseph's regularly supplies independent retail pharmacies in our community with COVID-19 vaccine. This challenging period has helped them to develop a strong network of sites in the area, and they will use these new relationships to better care for patients in their community and to be prepared to promptly respond to future public health emergencies.
  • Physician Leader: Ritesh Singh, MD
  • Pharmacist Leader: Kayla Ruppert, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Essentia Health Saint Mary's in Detroit Lakes utilizes pharmacy-driven antibiotic stewardship interventions, including formulary restrictions, guidelines for IV to oral conversion, and prospective audit with feedback.
  • Collaboration:
    Essentia Health St. Mary's Detroit Lakes provides support for clinicians out of regional clinic and critical access sites on request. This includes answering questions for initial treatment, treatment of patients with numerous antimicrobial allergies, and aiding with culture-guided treatment. Consult requests may come from providers or inpatient, clinic, or outpatient pharmacists. The St. Mary's team also provides antibiogram information to area nursing homes and others upon request.
  • Physician Leader: Gratia Pitcher, MD
  • Pharmacist Leader: Heather Cary, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    The Essentia Health Saint Mary's Medical Center antimicrobial stewardship team is diverse, with pharmacists, physicians, nursing and quality partners working together to provide annual education for all hospital staff on antimicrobial stewardship. The hospital's mission to combat antibiotic resistance includes prevention of hospital-associated infections and provision of safe care safe through effective antimicrobial therapy.
  • Collaboration:
    Essentia Health St. Mary's Medical Center works closely with Essentia Health Duluth Hospital and Essentia Health St. Mary's Hospital of Superior when transitioning patients from the hospital for continued care. St. Mary's Medical Center also works with Option Care when patients being monitored on antimicrobials are discharged to home care, ensuring communication about the organism causing infection, drug susceptibilities, acute care treatment received, and pharmacokinetic data to ensure seamless transitions to home. The team also engages work with the Sexual Assault Nurse Examining Team to ensure current antimicrobial and antiviral therapy recommendations are implemented.
  • Physician Leader: Malati Pemmaraju, MD
  • Pharmacist Leader: Tara Parks, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Essentia Health Virginia tracks recommendations for stewardship recommendations, and clinical acceptance of those recommendations, within the electronic medical record software.
  • Collaboration:
    Essentia Health Virginia hospital pharmacists provide formal consultation for the local nursing home, offering recommendations to optimize antibiotic treatment for long-term care residents.
  • Physician Leader: Simon Lick, MD
  • Pharmacist Leader: Tyler Waller, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Medical charts of mid-level practitioners are reviewed quarterly by the antimicrobial stewardship committee to ensure the hospital is maintaining a high level of care. In addition, members have been added to the antimicrobial stewardship committee to include representation from local nursing homes. This allows Grand Itasca Hospital, the primary location of health care for nursing home residents, to hear and react to the challenges faced in those facilities.
  • Collaboration:
    Grand Itasca works with providers who round in local nursing homes to implement workflows to support diagnosis and appropriate treatment of urinary tract infection. When a resident develops potential signs or symptoms of urinary tract infection, nursing home staff review a support tool to determine whether a provider needs to be contacted to discuss antibiotic therapy. In addition to supporting real-time decision-making, Grand Itasca hopes to use this tool to quantify unnecessary antibiotic courses averted.
  • Physician Leader: R. Bryan Rock, MD
  • Pharmacist Leader: Aileen Ahiskali, PharmD, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    Hennepin County Medical Center conducts real-time tracking of Staphylococcus aureus bacteremia and fungemia to ensure all patients with a positive blood culture are seen by Infectious Diseases (ID) Department. The ID pharmacist runs a report daily to ensure no cases are missed. This is back-up strategy ensures the ID service is alerted if the microbiology laboratory does not successfully make initial contact.
  • Collaboration:
    The Hennepin County Medical Center ID pharmacist provides consultation to Healthcare for the Homeless to optimize outpatient antibiotic use for an underserved population. Additionally, the ID pharmacist has ID pharmacy residents from an outside institution on rotation each year to provide them insight into stewardship practices.
  • Physician Leader: Adrianne Moen, MD, FFAAFP  
  • Pharmacist Leader: Nicole M Nelson, PharmD, BCPS
  • Highlighted Antibiotic Stewardship Activity:
    The Clinical Pharmacy team at Lakewood Health System (LHS) is responsible for completing a thorough review of prescribed antibiotic therapy. This process begins at initiation of treatment and again at 48 hours. Pharmacy recommendations regarding appropriate choice of antibiotic therapy, dosing frequency, treatment duration, de-escalation of therapy, IV to oral interchange, and other pertinent clinical information is discussed daily with providers at the interdisciplinary team meeting. The process facilitates care coordination required for planned outpatient parenteral antibiotic therapy and has led to a decrease in broad-spectrum antibiotic use within the system. The process also allows for prompt education on current guidelines and recommendations for treatment of common infections.
  • Collaboration:
    The Antimicrobial Stewardship (AMS) Committee at LHS consists of various system leaders, including nursing leadership from the LHS Care Center. Leadership from the care center attend quarterly AMS meetings to report on prescribing practices and resistance issues identified at the institution. Through collaboration with care center leadership, annual antimicrobial stewardship education was created. Antibiotic stewardship knowledge is continuously exchanged through this partnership.
  • Physician Leader: Alan Grillo, MD
  • Pharmacist Leader: David Simmons, PharmD, BCPS, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    LifeCare Antimicrobial Stewardship team implemented a COVID-19 response program that allowed the team to rapidly identify, triage, and treat high-risk COVID-19 patients with antivirals or monoclonal antibodies to prevent worsening illness and hospitalizations.
  • Collaboration:
    Collaboration with retail pharmacies has supported maintenance of adequate supplies and proper usage of oral antivirals for patients in the community with Covid-19. LifeCare hospital's antibiogram is shared with local pharmacies, clinic providers, and the long-term care facilities Greenbush Manor and Roseau Manor. Physicians providing care to residents at these long-term care facilities are part of the LifeCare medical staff and receive pharmacy-led education at medical staff meetings.
  • Physician Leader: Edwin Pereira, MD
  • Pharmacist Leader: Sherri Jobin, PharmD, BCPS, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    M Health Fairview Bethesda Hospital utilizes Bayesian area under the curve methodology for dosing and monitoring vancomycin. This best practice was implemented in 2021, and evaluation of clinical outcomes associated with this change in practice is underway overall and for several special populations (e.g., patients on continuous renal replacement therapy and CNS infections) where data are lacking to inform practices.
  • Collaboration:
    M Health Fairview Bethesda Hospital participates in the Minnesota Department of Health NHSN AU Option User Group which meets quarterly to discuss trends in antimicrobial use and facilitate information exchange between health systems in Minnesota.
  • Physician Leader: Aditya Chandorkar, MBBS
  • Pharmacist Leader: Jennifer Ross, PharmD, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    M Health Fairview Lakes Medical Center tracks antimicrobial stewardship intervention acceptance rates (interventions accepted within 24 hours of formal progress note). Other variables tracked include days of therapy (DOT) for all antimicrobials, with data accessible in the electronic health record and in NHSN AU Standardized Antimicrobial Administration Ratio (SAAR) reports. Review of DOT and SAAR in tandem allows the team to target antimicrobial stewardship interventions including retrospective chart review for specific antimicrobials and/or disease states.
  • Collaboration:
    M Health Fairview Lakes provides tele-antimicrobial stewardship to others in the M Health Fairview system. They have focused on building trust and ensuring sound communication methods and have established formal collaboration with an ED provider to improve use of non-restricted and restricted antimicrobials for skin and soft-tissue infection (SSTI). Through regular meetings with the ED provider, they have reviewed over 100 patients seen in the ED and subsequently admitted with SSTI. These data have informed an SSTI guideline for Lakes and other M Health Fairview sites that includes "hospital-at-home" therapy considerations. This initiative goes beyond daily antimicrobial stewardship workflows, which largely focus on inpatients. Hospital-at-home is a care transition that poses unique antimicrobial stewardship challenges for parenteral antimicrobial therapy.
  • Physician Leader: Laura Norton, MD, MS
  • Pharmacist Leader: Meredith Oliver, PharmD, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    The pediatric antimicrobial stewardship team uses prospective audit with feedback to prescribers and incorporates handshake stewardship into daily stewardship rounds. The team also partners with providers to create local clinical practice guidance to optimize antimicrobial use. An example of the success of this collaboration was a substantial decrease in broad-spectrum antibiotic use in the NICU following collaboration with neonatology providers in creating guidelines for multiple neonatal conditions with continued prospective audit with feedback.
  • Collaboration:
    The Masonic Children's antimicrobial stewardship team engages with stewardship teams at other M Fairview hospitals to ensure protocols, outcomes measurement, and educational efforts are consistent across hospitals for pediatric patients. Antimicrobial stewardship engaged in systemwide order-set revisions for early onset sepsis and infant fever (0-60 days of life) to be consistent with updated national guidelines.
  • Physician Leader: Aditya Chandorkar, MBBS
  • Pharmacist Leader: Jennifer Ross, PharmD, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    M Health Fairview Northland Regional Hospital is developing an antimicrobial stewardship dashboard for providers, pharmacists, and infection preventionists to communicate data on use of broad spectrum antimicrobial classes (i.e., anti-MRSA agents, anti-Pseudomonas aeruginosa agents, carbapenems) and quantity of completed beta-lactam allergy assessments.
  • Collaboration:
    The M Health Fairview Northland Regional Hospital tele-antimicrobial stewardship program provides formal mentorship to an acute care site of similar size in the M Health Fairview system that has no onsite ID consultation service or provider. Mentorship has included sharing of tracking, reporting, and assessment practices, joint rounds, and participation in daily antimicrobial stewardship workflows within the electronic medical record system and directly with providers through tele-stewardship. The Northland Regional Hospital team serves as a resource to discuss difficult inpatient and outpatient cases.
  • Physician Leader: Steven Dittes, MD
  • Pharmacist Leader: Ronald Greenberg, PharmD, BCPS
  • Highlighted Antibiotic Stewardship Activity:
    M Health Fairview Ridges uses prospective audit with feedback to educate providers and improve antibiotic use for individual patients. Any antimicrobial included in the facility's antimicrobial use policy, and any medication under FDA Emergency Use Authorization for COVID-19, triggers prospective audit with feedback. Provider feedback is given through multiple modes, including progress notes in the medical chart, page to the primary provider, phone, or in-person conversation.
  • Collaboration:
    M Health Fairview Ridges Hospital Hospital participated in a system quality improvement project to reduce the incidence of surgical site infections (SSIs), especially associated with knee arthroplasty procedures. Incorrect preoperative antibiotic timing in relation to time of surgical incision was identified as the primary cause of an increase in SSIs across the system. M Health Fairview Ridges was chosen as the pilot site for targeted process improvement initiatives.
  • Physician Leader: Steven Dittes, MD
  • Pharmacist Leader: Carolyn Brands, PharmD, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    M Health Fairview Southdale reviews antibiotic-use data monthly and quarterly to identify trends and/or specific medications that may need targeted interventions to ensure appropriate use. The hospital also participates in the CDC's National Healthcare Safety Network Antibiotic Use Option to compare antibiotic use to that of similar hospitals.
  • Collaboration:
    M Health Fairview Southdale Hospital participates in the Minnesota Department of Health National Healthcare Safety Network Antimicrobial Use Option User Group which meets quarterly to discuss trends in antimicrobial use and facilitate information exchange between health systems in Minnesota.
  • Physician Leader: Edwin Pereira, MD
  • Pharmacist Leader: Sherri Jobin, PharmD, BCPS, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    M Health Fairview St. John's Hospital utilizes Bayesian area under the curve methodology for dosing and monitoring vancomycin. This best practice was implemented in 2021, and evaluation of clinical outcomes associated with this change in practice is underway overall and for several special populations (e.g., patients on continuous renal replacement therapy and CNS infections) where data are lacking to inform practices.
  • Collaboration:
    M Health Fairview St. John's Hospital participates in the Minnesota Department of Health NHSN AU Option User Group which meets quarterly to discuss trends in antimicrobial use and facilitate information exchange between health systems in Minnesota.
  • Physician Leader: Edwin Pereira, MD
  • Pharmacist Leader: Sherri Jobin, PharmD, BCPS, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    M Health Fairview Woodwinds Hospital utilizes Bayesian area under the curve methodology for dosing and monitoring vancomycin. This best practice was implemented in 2021, and evaluation of clinical outcomes associated with this change in practice is underway overall and for several special populations (e.g., patients on continuous renal replacement therapy and CNS infections) where data are lacking to inform practices.
  • Collaboration:
    M Health Fairview Woodwinds Hospital participates in the Minnesota Department of Health NHSN AU Option User Group which meets quarterly to discuss trends in antimicrobial use and facilitate information exchange between health systems in Minnesota.
  • Physician Leader: Susan Kline, MD
  • Pharmacist Leader: Kimberly Boeser, PharmD, MPH, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    M Health Fairview University of Minnesota Medical Center utilizes Bayesian area under the curve methodology for dosing and monitoring vancomycin. This best practice was implemented in 2021, and evaluation of clinical outcomes associated with this change in practice is underway overall and for several special populations (e.g., patients on continuous renal replacement therapy and CNS infections) where data are lacking to inform practices.
  • Collaboration:
    University of Minnesota Medical Center participates in the Minnesota Department of Health NHSN AU Option User Group which meets quarterly to discuss trends in antimicrobial use and facilitate information exchange between health systems in Minnesota.
  • Physician Leader: Gina Suh, MD
  • Pharmacist Leader: Kelsey Jensen, PharmD, BCPS, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    Vertical antimicrobial stewardship initiatives are used to educate pharmacists and providers and optimize antimicrobial use for a particular disease state. In March 2021, educational presentations were delivered to targeted groups detailing guideline-driven treatment of intra-abdominal infections (IAI). Following education, inpatient pharmacists were encouraged to contact providers if unnecessarily broad therapy was initiated for the treatment of IAI to suggest preferred antimicrobial regimens. Across the Mayo Clinic Health System Southeast Minnesota region, piperacillin/tazobactam utilization for IAI indications decreased from 13.5 days of therapy (DOT)/1000 patient days in 2019-2020 to 7 DOT/1000 patient days in April-June 2021. Ciprofloxacin utilization for IAI indications decreased from 5.1 days of therapy (DOT)/1000 patient days to 1.3 DOT/1000 patient days for the same timeframe.
  • Collaboration:
    Mayo Clinic Health System (MCHS) Austin/Albert Lea hospital provides remote stewardship services including prospective audit and feedback to other MCHS hospitals in Red Wing, Cannon Falls, and Lake City and leads collaborative outpatient antimicrobial stewardship initiatives for nearby MCHS outpatients clinics. All MCHS Minnesota hospitals are currently participating in a quality improvement project aimed at decreasing the total duration of antibiotics for CAP. Pharmacists are monitoring discharge prescriptions and recommending adjustments if the total duration (inpatient antibiotics plus discharge prescription(s)) exceeds guideline recommendations. This initiative aims to decrease outpatient antibiotic use in the community.
  • Physician Leader: Cristina Corsini Campioli, MD
  • Pharmacist Leader: Kellie Hannan, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Mayo Clinic Mankato uses electronic health records (EHR) functionality for stewardship. Clinical indication information is required for inpatient antimicrobial orders, and this electronic data can be filtered for analysis. The EHR is system is programmed with monitoring rules so that potentially inappropriate antimicrobial therapy can be quickly identified and reviewed by the stewardship pharmacist on a daily basis. A multidisciplinary team at Mayo Clinic Mankato actively reviews hospital-acquired C. difficile cases to inform prevention initiatives.
  • Collaboration:
    Mayo Clinic Health System (MCHS) Mankato hospital provides remote stewardship services including prospective audit and feedback to other MCHS hospitals in Fairmont, New Prague, St. James, and Waseca and leads collaborative outpatient antimicrobial stewardship initiatives for nearby MCHS outpatients clinics. All MCHS Minnesota hospitals are currently participating in a quality improvement project aimed at decreasing the total duration of antibiotics for community-acquired pneumonia. Pharmacists are monitoring discharge prescriptions and recommending adjustments if the total duration (inpatient antibiotics plus discharge prescription(s)) exceeds guideline recommendations. This initiative aims to decrease outpatient antibiotic use in the community.
  • Physician Leader: Gina Suh, MD
  • Pharmacist Leader: Kelsey Jensen, PharmD, BCPS, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    A vertical antimicrobial stewardship initiative is undertaken as least annually to educate pharmacists and providers and to optimize antimicrobial use for a particular disease state. In March 2021, educational presentations were delivered to targeted groups detailing guideline-driven treatment of intraabdominal infections (IAI). Following this education, inpatient pharmacists were encouraged to contact providers if unnecessarily broad therapy was initiated for the treatment of IAI to suggest preferred antimicrobial regimens. Across the Mayo Clinic Health System (MCHS) Southeast Minnesota region, piperacillin/tazobactam utilization for IAI indications decreased from 13.5 days of therapy (DOT)/1000 patient days (using 2019 2020 data as baseline) to 7 DOT/1000 patient days in the post-intervention period (April-June 2021). Additionally, ciprofloxacin utilization for IAI indications also decreased from 5.1 days of therapy (DOT)/1000 patient days (using 2019-2020 data as baseline) to 1.3 DOT/1000 patient days in the post-intervention period (April-June 2021).
  • Collaboration:
    MCHS Southeast Minnesota Region Antimicrobial Stewardship Program Team provides stewardship services to MCHS hospitals within the region including Austin, Albert Lea, Red Wing, Lake City, and Cannon Falls, and to nearby MCHS outpatient clinics. Antimicrobial use data are tracked and reported for the entire MCHS Southeast Minnesota region. Stewardship education is provided to staff throughout the region, and stewardship initiatives are generally implemented concurrently at all sites. The MCHS Southeast Minnesota Region Antimicrobial Stewardship Program team regularly collaborates with the MCHS Southwest Minnesota ASP team to develop and implement stewardship initiatives such as the intraabdominal infection vertical stewardship initiative (described above). The Southeast and Southwest teams meet at least quarterly. There is also regular collaboration between Antimicrobial Stewardship Teams at all Mayo Enterprise sites. The Enterprise Antimicrobial Stewardship Team meets bi-monthly to discuss ongoing projects and to facilitate collaboration and cross-pollination of ideas.
  • Physician Leader: Cristina Corsini Campioli, MD
  • Pharmacist Leader: Kellie Hannan, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    In August 2021, educational presentations were delivered to targeted groups detailing guideline-driven treatment of urinary tract infections (UTI) and asymptomatic bacteriuria. Following this education, inpatient pharmacists were encouraged to contact providers to recommend discontinuation of antibiotics for asymptomatic bacteriuria or de-escalation of antibiotics for UTI based on culture results if clinically appropriate. Across the Mayo Clinic Health System (MCHS) Southwest Minnesota region, ceftriaxone utilization for UTI indications decreased from 20.2 days of therapy (DOT)/1000 patient days in 2020 to 18.1 DOT/1000 patient days in the post-intervention period (September-December 2021).
  • Collaboration:
    MCHS Southwest Minnesota Region Antimicrobial Stewardship Program Team provides stewardship services to MCHS hospitals in Mankato, Fairmont, New Prague, St. James, and Waseca and to nearby MCHS outpatient clinics. Antimicrobial use data are tracked and reported for the MCHS Southwest Minnesota region. Providers and infection preventionists from multiple sites participate in regional stewardship meetings to share ideas and coordinate efforts. Stewardship education is provided to staff throughout the region, and stewardship initiatives are generally implemented concurrently at all sites. The MCHS Southwest Minnesota ASP team regularly collaborates with the MCHS Southeast Minnesota ASP team to develop and implement stewardship initiatives such as the UTI vertical stewardship initiative (described above).
  • Physician Leader: Aaron Tande, MD
  • Pharmacist Leader: Lynn Estes, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    The Mayo Clinic Rochester antimicrobial stewardship team completes daily reviews of inpatients receiving potentially suboptimal antimicrobial therapy. Patients are identified through internally developed rule algorithms applied in the electronic medical record system. Inpatient reporting is done via an internally developed antimicrobial analytics program that allows selection of date range, numerous grouping and filtering options (units, provider teams, indications, selected drugs etc.), and also selection of several different metrics. Beyond the inpatient care setting, a multifaceted approach to outpatient antimicrobial stewardship has included implementation of evidence-based guidelines and tracking and reporting of outpatient prescribing data. Clinical resources for antimicrobials and infectious syndrome management are available to all staff through the "Ask Mayo Expert" program and the Mayo Clinic Antimicrobial Therapy Quick Guide.
  • Collaboration:
    The Mayo Clinic Rochester antimicrobial stewardship program is responsible for stewardship activities within two acute care medical centers (Rochester Methodist Hospital and Saint Mary's Hospital) and has implemented efforts to optimize antimicrobial use in primary, urgent, and emergency care for a large ambulatory practice encompassing several clinic locations in Rochester and surrounding communities. The Mayo Clinic Rochester team is also active in the Enterprise Antimicrobial Stewardship program, which coordinates efforts across all Mayo Clinic sites to collaborate on projects and program optimization pertaining to antimicrobial stewardship. Enterprise-wide initiatives include development of platforms to facilitate antimicrobial benchmarking, refinement of clinical pathways, local guidelines, and order sets, quality improvement projects (e.g., prescribing for inpatients with pneumonia), educational activities, and refinement of prospective audit rules.
  • Physician Leader: Becca Peglow, MD
  • Pharmacist Leader: Kelly Becicka, PharmD; Zack Nelson, PharmD; Galina Shteyman, PharmD; Leah Nelson, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    The Park Nicollet Methodist Hospital antimicrobial stewardship team has implemented initiatives to optimize antibiotic initiation and discontinuation in patients with febrile neutropenia and pre-operative antibiotics in patients with history of antimicrobial allergies. They have also evaluated the impact of prospective pharmacist review of prescriptions upon emergency department discharge.
  • Collaboration:
    Park Nicollet Methodist Hospital partnered with the HealthPartners Outpatient Antimicrobial Stewardship Committee to evaluate inappropriate treatments for upper respiratory tract infections and provide smart sets for UTI and antimicrobial allergy assessment.
  • Physician Leader: Becca Peglow, MD
  • Pharmacist Leader: Mary Ullman, PharmD, BCPS, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    The Regions Hospital antimicrobial stewardship team has an initiative to decrease length of stay for long-term antimicrobial treatment patients who have risk factors that may contraindicate IV therapy on discharge.
  • Collaboration:
    Regions Hospital has collaborated with other hospitals on COVID-19 treatment guidelines and interventions to discourage antimicrobial use in early treatment of COVID-19 patients. They also collaborate with the Outpatient HealthPartners Antimicrobial Stewardship Committee to optimize appropriate treatments for upper respiratory tract and urinary tract infections. Regions collaborates with Methodist Hospital to develop treatment guidelines for escalation or de-escalation of antimicrobials based on blood culture results.
  • Physician Leader: Lucio Minces, MD
  • Pharmacist Leader: Nathan Goracke, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Clinical pharmacists review daily antimicrobial use reports, including every ordered antibiotic, antiviral, and antifungal prescription, to ensure appropriate use. Interventions can then be made on the basis of such review, if necessary.
  • Collaboration:
    Rice Memorial participates in a collaborative, multi-site antimicrobial stewardship program with seven other hospital sites, meeting at least quarterly to share insight, protocols, and stewardship information. In addition, the Rice Memorial infectious disease (ID) physician mentors and facilitates stewardship practices with four other area facilities, providing important expertise and consulting on initiatives. Rice Memorial also hosts a monthly ID journal club via teleconference with other facilities in the region, and shares their antibiogram data with more than ten other sites.
  • Physician Leader: Elliot Francke, MD
  • Pharmacist Leader: Kelly Kabat, PharmD, BCPS
  • Highlighted Antibiotic Stewardship Activity:
    The Ridgeview Medical Center antimicrobial stewardship committee conducts case-based reviews of rejected stewardship interventions. If a rejected intervention has broader impact (e.g., not following evidence-based guideline processes), education is created and shared with individual providers or across the organization, as appropriate.
  • Collaboration:
    Ridgeview Medical Center partners with two critical access hospital sites, Arlington and Le Sueur, to support antimicrobial stewardship initiatives. Team members from both sites participate in monthly committee meetings. In addition, the antimicrobial stewardship committee has expanded to include a clinic pharmacist. This change is intended to bring more stewardship activities into clinic locations and was implemented at the request of clinic providers looking for more antimicrobial use education.
  • Physician Leader: Sara Lund, MD
  • Pharmacist Leader: Joy Bittner, PharmD, BCPS
  • Highlighted Antibiotic Stewardship Activity:
    Inpatient pharmacists and infectious diseases physicians conduct antibiotic stewardship rounds twice weekly and communicate recommendations to attending providers. The antimicrobial stewardship committee has focused efforts on improving antibiotic use in patients with beta-lactam allergies or adverse drug reactions, and optimizing perioperative cefazolin use for surgical patients.
  • Collaboration:
    St. Luke's inpatient pharmacists and infectious diseases physicians have collaborated with rural hospitals who are members of Wilderness Health to be available for antimicrobial or infectious disease questions and discussion.
  • Physician Leader: Stephen Davis, MD
  • Pharmacist Leader: Michelle Hinojos, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    The Tri-County Health Care (TCHC) Antimicrobial Stewardship (AMS) Team initiated an MRSA PCR-based nasal screening process that has been successfully used organization-wide to de-escalate vancomycin usage. TCHC AMS team implemented measures around clinical indication for all new antibiotic orders including building an 11-disease state infectious disease order set along with pneumonia and sepsis order set updates . The AMS team also created a PowerPoint presentation and questionnaire that is incorporated into the annual employee education module. This educational program is required to be completed annually by all patient care staff (including nurses, lab technicians, pharmacy staff, others) as well as advanced practice providers. "Needs to improve" case examples are used to educate staff during stewardship team meetings, and provider education and order sets are used to address antibiotic prescribing gaps in practice.
  • Collaboration:
    TCHC works with colleagues and outside facilities such as nursing homes to mentor on antibiotic resistance and antimicrobial stewardship. Shared order sets and protocols help local facilities to use best practice guidelines, and collaborative projects (e.g., reduction of quinolone use) have resulted in improved outcomes like lower Clostridioides difficile rates. The TCHC AMS team has also worked with local retail pharmacies on issues of antibiotic access and care transitions and has developed outpatient clinic smart sets for pneumonia, UTI, sinusitis, bronchitis, and diarrhea.
  • Physician Leader: Brian Niskanen, MD
  • Pharmacist Leader: Nicholas Giller, PharmD, BCPS, BCOP, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    Welia Health conducts an annual retrospective analysis focusing on outpatient prescribing for urinary tract infection, community-acquired pneumonia, sinusitis, otitis media, and diverticulitis. They also annually review prescribing (i.e., days of therapy) and purchasing data to identify opportunities for prescribing behavior change, and develop a facility-specific antibiogram.
  • Collaboration:
    Welia Health has focused on limiting duration of antibiotic therapy at discharge to ensure stewardship is maintained across care transitions. The Welia stewardship pharmacist also engages with pharmacists from other small critical access hospitals in the area to support their antibiotic stewardship programs.

*This honoree has Minnesota One Health Antibiotic Stewardship Collaborative member(s).
†This facility utilizes the NHSN Antimicrobial Use (AU) Option.

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Silver Level

  • Silver hospitals practice the following antibiotic stewardship actions:
    • Antibiotic use tracking
    • Antibiotic use reporting
    • Use of hospital-specific evidence-based treatment and prescribing guidelines
    • Use of hospital-specific antibiogram
    • Additional stewardship intervention
      Intervention actions are highlighted below.
  • Silver Level hospitals have also achieved Bronze Level requirements for commitment.

2022 Minnesota Antibiotic Stewardship Acute Care and Critical Access Silver Level Honor Roll Honorees

  • Physician Leader: Gina Suh, MD
  • Pharmacist Leader: Kelsey Jensen, PharmD, BCPS, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    Mayo Clinic Cannon Falls conducts retrospective case review with providers, RNs, and pharmacy to identify opportunities to improve antibiotic therapy.
  • Physician Leader: Cristina Corsini Campioli, MD
  • Pharmacist Leader: Kellie Hannan, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Order sets within the electronic medical record system have been built to facilitate guideline concordant antimicrobial prescribing. Example inpatient order sets include sepsis, pneumonia, C. difficile, cellulitis, and intra-abdominal infection.
  • Physician Leader: Gina Suh, MD
  • Pharmacist Leader: Kelsey Jensen, PharmD, BCPS, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    In August 2021, educational presentations were delivered to targeted groups detailing guideline-driven treatment of urinary tract infections (UTI) and asymptomatic bacteriuria. Inpatient pharmacists contact providers to recommend discontinuation of antibiotics for asymptomatic bacteriuria or de-escalation of antibiotics for UTI based on culture results, if clinically appropriate.
  • Physician Leader: Cristina Corsini Campioli, MD
  • Pharmacist Leader: Kellie Hannan, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Mayo Clinic New Prague incorporates preauthorization of restricted antimicrobials as a pharmacy-driven approach to educate providers and optimize antimicrobial use.
  • Physician Leader: Gina Suh, MD
  • Pharmacist Leader: Kelsey Jensen, PharmD, BCPS, BCIDP
  • Highlighted Antibiotic Stewardship Activity:
    Mayo Clinic Red Wing utilizes antimicrobial formulary restriction for a list of antimicrobials reserved for specific use scenarios. If a medication from the restricted antimicrobials list is ordered, pharmacy will verify and ensure that restriction criteria are met prior to order verification.
  • Physician Leader: Cristina Corsini Campioli, MD
  • Pharmacist Leader: Kellie Hannan, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    The Mayo Clinic St. James outpatient antimicrobial stewardship goal for 2021 was to reduce antibiotic prescribing for upper respiratory infections (URIs), focusing on viral URIs where antibiotics are not indicated. Educational presentations were given to ED and family medicine provider groups to review antibiotic recommendations for URIs, communication strategies for patients who request antibiotics for viral infections, and symptomatic management recommendations.
  • Physician Leader: Cristina Corsini Campioli, MD
  • Pharmacist Leader: Kellie Hannan, PharmD
  • Highlighted Antibiotic Stewardship Activity:
    Antibiotic use data are available via a dashboard that allows for filtering by antimicrobial, indication of use, facility, unit, etc. Ciprofloxacin, levofloxacin, cefepime, piperacillin/tazobactam, ceftriaxone, ertapenem, meropenem, daptomycin, and vancomycin usage is reported to key stakeholders quarterly. Changes in antibiotic use may prompt medication use evaluations to assess appropriateness of use and/or other interventions as needed.

*This honoree has Minnesota One Health Antibiotic Stewardship Collaborative member(s).
This facility utilizes the NHSN Antimicrobial Use (AU) Option.

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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.

All 2022 honorees achieved Silver or Gold Level.

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 Wednesday, 28-Sep-2022 14:44:03 CDT