Urgent Care Foundation

URGENT CARE INDUSTRY ANTIBIOTIC STEWARDSHIP INITIATIVE: PATIENT EDUCATION PROGRAMS AND CLINICAL EDUCATION STRATEGIES TO INFORM, ASSESS AND IMPROVE THE ANTIBIOTIC PRESCRIBING PRACTICES - URGENT CARE CENTERS TREAT MORE THAN 160 MILLION PATIENTS EACH YEAR, THE VAST MAJORITY OF WHOM PRESENT WITH ACUTE, INFECTIOUS DISEASE-RELATED SYMPTOMS, SUCH AS COUGH, SORE THROAT, AND FEVER. OVER THE PAST 2 YEARS, THE URGENT CARE INDUSTRY HAS TREATED A RECORD VOLUME OF PATIENTS FOR COVID-19 INFECTIONS. THE URGENT CARE ASSOCIATION (UCA) AND THE URGENT CARE FOUNDATION (UCF) SERVE OVER 11,000 URGENT CARE CENTERS ACROSS THE COUNTRY WHICH ARE TREATING PATIENTS WHERE THE DECISION TO PRESCRIBE OR NOT WITH ANTIBIOTICS IS MADE SEVERAL TIMES A DAY. URGENT CARE CLINICIANS ARE PARTICULARLY SUSCEPTIBLE TO PATIENT EXPECTATIONS AND DEMANDS FOR ANTIBIOTICS, LARGELY DUE TO MISPERCEPTIONS ABOUT PATIENT EXPECTATIONS AND THE "YELP EFFECT." THE UCA/UCF HAVE DEVELOPED RESOURCES, IMPLEMENTED STANDARDS AND EDUCATION TO IMPROVE ANTIBIOTIC PRESCRIBING PRACTICES IN THE URGENT CARE INDUSTRY. ADDITIONALLY, UCA/UCF HAS PARTNERED WITH THE CDC AND COLLABORATED WITH OTHER EXTERNAL STAKEHOLDERS TO EDUCATE CLINICIANS AND CONTINUE OUR PROGRESS TO IMPROVE ANTIBIOTIC STEWARDSHIP. THERE HAS BEEN RECENT IMPROVEMENT IN THE INDUSTRY; HOWEVER, RECENT CDC DATA SUGGESTS THAT PATIENTS ARE CONTINUING TO RECEIVE AN ANTIBIOTIC PRESCRIPTION AFTER BEING DIAGNOSED AT URGENT CARE CENTERS EVEN THOUGH ANTIBIOTICS ARE CONTRAINDICATED. OVERALL, MORE THAN 12% OF AMBULATORY VISITS RESULT IN PRESCRIPTIONS FOR ANTIBIOTICS. ANTIBIOTICS ARE PRESCRIBED IN 39% OF URGENT CARE VISITS, 36.4% OF RETAIL CLINIC VISITS, AND 7.1% OF MEDICAL OFFICE VISITS. ROUGHLY 30% OF ANTIBIOTICS PRESCRIBED IN OUTPATIENT SETTINGS ARE UNNECESSARY, ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). THE UCA/UCF WILL LAUNCH A LARGE, MULTI-CENTER QUALITY IMPROVEMENT PROJECT WITH THE GOAL TO INFORM STEWARDSHIP INTERVENTION AND IMPROVE ANTIBIOTIC PRESCRIBING IN URGENT CARE CENTERS. USING EXISTING GUIDANCE AND CREATING NEW, UPDATED RESOURCES SPECIFIC TO URGENT CARE PROVIDERS, RECRUITED PARTICIPANTS TO FOLLOW A STRUCTURED PROGRAM OF INTERVENTION AND REPORTING, ASSESS ANTIBIOTIC STEWARDSHIP IN THEIR INSTITUTIONS AND RECEIVE RESOURCES TO IMPLEMENT ANTIBIOTIC PRESCRIBING BEST PRACTICES. RESOURCES WILL INCLUDE MULTI-MEDIA FORMATS, SUCH AS SIGNAGE, SOCIAL MEDIA MATERIAL, PATIENT ENGAGEMENT TOOLS AND WEBINARS, AND ADDRESS BOTH PATIENT EDUCATION AND PROVIDER EDUCATION. BASELINE DATA WILL BE ESTABLISHED AMONG PARTICIPANTS, AND CONTINUED DATA COLLECTION WILL OCCUR MONTHLY TO GUIDE REPORTING AND TRACK PROGRESS OF FAVORABLE TRENDLINES DEMONSTRATING SUCCESSFUL IMPLEMENTATION OF ANTIBIOTIC STEWARDSHIP FRAMEWORKS. THROUGHOUT THE PROJECT, PARTICIPANTS WILL ASSESS CONTINUING GAPS AND IDENTIFY ADJUSTMENTS TO TRAINING AND INTERVENTION RESOURCES. ULTIMATELY, THE PROJECT WILL ADDRESS TWO EXISTING KNOWLEDGE GAPS: 1.PATIENTS ARE CONTINUING TO RECEIVE AN ANTIBIOTIC PRESCRIPTION AFTER BEING DIAGNOSED AT URGENT CARE CENTERS EVEN THOUGH ANTIBIOTICS ARE CONTRAINDICATED. 2.CLINICIANS ARE NOT AWARE OF DATA AND DECISION-MAKING STRATEGIES TO ADDRESS PATIENT EXPECTATIONS OF RECEIVING ANTIBIOTICS AND PROVEN TECHNIQUES TO MITIGATE OVERPRESCRIBING. THE PROJECT WILL SUPPORT THREE OUTCOMES IN IMPROVING ANTIBIOTIC PRESCRIBING: 1.INCREASE THE NUMBER OF URGENT CARE CENTERS WITH EFFECTIVE ANTIBIOTIC STEWARDSHIP PROGRAMS 2.DECREASE THE RATE OF UNNECESSARY ANTIBIOTIC PRESCRIBING WITHIN THE URGENT CARE SETTING 3.INFORM AND ASSESS EXISTING STEWARDSHIP INTERVENTION TO PROVIDE EFFECTIVE FRAMEWORK AND RESOURCES FOR PROVIDERS TO IMPLEMENT BEST PRACTICES