healthcare value analysis
By Barbara Strain , MA , SM ( ASCP ), CVAHP
The Role of Value Analysis in Antibiotic Stewardship
The link between products , equipment , and practice compliance especially during disruptive periods can have an impact on infection prevention and control as well as antibiotic stewardship efforts .
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In
2014 the Centers for Disease Control and
Prevention ( CDC ) called upon U . S . hospitals to implement antibiotic stewardship programs using the Core Elements of Hospital Antibiotic Stewardship Programs 1 which was subsequently updated in 2019 . The seven core elements also form the foundation for antibiotic stewardship accreditation standards from The Joint Commission and DNV-GL . All leaders , physicians , clinicians , and staff working in healthcare settings should be aware of their organization ’ s antibiotic stewardship efforts and understand the part they can play in supporting these programs .
Hospital antibiotic stewardship programs ( ASP ) can increase infection cure rates while reducing :
● Treatment failures
● C . difficile infections
● Adverse effects
● Antibiotic resistance
● Hospital costs and lengths of stay
The key stakeholder groups mentioned in the Core Elements range from hospital epidemiologists , infection prevention and control ( IP & C ), infectious diseases and other physicians , pharmacists , quality officers and other leaders . Value analysis , although not mentioned in the seven core elements , could be the eighth element .
Value analysis programs are commonly structured into one or more teams of subject matter experts ( SMEs ) who review current products and services to assure they continue to provide total value to the organization in meeting its clinical and financial goals as well as use proven processes to review new technologies and devices , information technology-based services – such as sensor-based monitoring , artificial intelligence ( AI ), telehealth and out-of-hospital based solutions .
In 2016 the Centers for Medicare and Medicaid Services ( CMS ) re-introduced the Conditions of Participation to reflect current standards of practice and to support improvements in quality of care 2 by :
● Reducing readmissions
● Reducing barriers to care
● Reducing the incidence of hospital-acquired conditions ( including healthcare-associated infections )
● Improving the use of antibiotics ( including the potential for reduced antibiotic resistance )
● Addressing workforce shortage issues
● Improving patient protections
The “ conditions ” significantly changed the landscape of new medical device review that continues today . Suppliers now market new products , equipment and services solutions to value analysis and SMEs primarily using clinical-based evidence to back up claims of reducing HAIs and / or HACs , improving quality , reducing readmissions , and decreasing emergency department visits while assisting hospitals in meeting their antibiotic stewardship goals .
To put these scenarios into perspective some examples include but are not limited to medical devices that will prevent the acquisition of infections or assist in treating them effectively without long courses of antibiotics such as :
● Antibiotic or metal impregnated / coated central line catheters , urinary catheters , dressings , stents , bone cement , bed linens , cubical curtains
● Microbiology culture specimen collection devices
● Rapid bacterial identification and antibiotic testing methodologies
● Patient bathing with pH balanced cleansing agents
● Healthcare workers , others alcohol-based hand sanitizers
● Software-based solutions , such as assist in reducing surgical site infections by improving hand hygiene
● Other products and technology
The underlying theme is to prevent HAIs , which then leads to controlling the use of antibiotics .
No doubt you have seen the cargo ships anchored off the coastal harbors of California and New York waiting to dock and unload countless goods and food . The current wait for a dock spot is two and a half weeks . From there the cargo goes to warehouses where the loads are sorted and sent to their destinations . At that point it may be a month or two or three before medical supplies reach your care environment . What happens in those in-between-times are backorders . To add to these conditions are the discontinuation of products by suppliers due to a variety of issues from lack of raw materials , low usage , switch of manufacturing lines to other COVID-related needs and business reasons .
To overcome daily needs to ensure patients are cared for , value analysis professionals work with SMEs and supply chain to identify suitable substitutes meeting key functional criteria , sometimes lining up two or more substitutes depending on availability . Value analysis keeps a watchful eye on the key characteristics of the originally approved product but that
www . healthcarehygienemagazine . com • october 2021
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