By Anne Haddad, MPH, antimicrobial stewardship coordinator, Michigan Department of Health and Human Services, Surveillance for Healthcare-Associated Resistant Pathogens (SHARP) Unit, Lansing, Mich.
The Michigan Department of Health and Human Services (MDHHS) Surveillance for Healthcare-Associated and Resistant Pathogens (SHARP) Unit has been partnering with the Michigan Society of Health-System Pharmacists (MSHP) on promotion of antimicrobial stewardship (AMS) in the state. Members of the MSHP AMS Committee have been active participants in the AMS Subcommittee of the Healthcare-Associated Infections (HAI) Prevention Advisory Group led by MDHHS. The subcommittee is a multidisciplinary group of representatives in AMS across the state. Members include pharmacists, infectious disease physicians, epidemiologists, insurers, infection preventionists, veterinarians, quality representatives and the Michigan Health and Hospital Association (MHA). Members convene bimonthly to discuss current projects in AMS and to identify areas for collaboration and coordination.
The AMS Subcommittee has been integral in planning the upcoming One Health Antimicrobial Resistance Summit which will be held on Sept. 18, 2019, at the Henry Ford's Lovett Hall in Dearborn. The Summit is intended to bring together leaders in AMS from all areas in Michigan, including human health, animal health, agriculture and regulatory authorities. Sessions will cover the Antimicrobial Resistance (AMR) work already being done in each area to increase cross-sector awareness and knowledge and further promote work from a One Health perspective. The conference will be used as a kickoff for the development of a Michigan-specific AMR Action Plan based on the five-year National Action Plan for Combating Antibiotic-Resistant Bacteria. Building on the cross-sector collaboration of the Summit, the Plan will be used as a roadmap for Michigan AMS activities.
Current MDHHS' SHARP Unit Activities
MDHHS' SHARP Unit has been presenting HAI and AMR trainings titled "SHARP Symposiums" across the state. The daylong conferences provided AMR epidemiology updates, current reporting requirements, analysis assistance and stewardship resources for practitioners, including information on AMS in practice. Members of MSHP volunteered to provide local expertise for these sessions at each symposium. MSHP speakers served as knowledgeable resources for attendees and have been very well-received.
Additionally, the SHARP Unit is working on several data mining projects to determine the status of outpatient prescribing in the state. Outpatient claims data for antibiotic prescriptions will be obtained from Blue Cross Blue Shield of Michigan and Michigan Medicaid. The data will be used to identify areas of high prescribing to target and develop prescribing interventions. The SHARP Unit is also working with Ferris State University and Western Michigan University on the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM) project. This project creates a dashboard containing antibiotic prescription rates for participating outpatient facilities and compares each prescription to the Infectious Diseases Society of America (IDSA) guidelines as a measure of appropriateness. MDHHS is supporting the expansion of this project to better implement tracking and reporting for outpatient antibiotic stewardship programs and identify areas for improvement.
Data is also being gathered through National Healthcare Safety Network (NHSN) Antimicrobial Use (AU) Module reporting. The SHARP Unit is working with MSHP on promotion of the AU Module. Currently, Michigan has 26 hospitals regularly reporting into the module and sharing with MDHHS. The SHARP Unit is beginning to analyze this data and will work on developing reports to share with participating facilities and partners.
MDHHS works closely with many partners on stewardship activities and education, including the Lake Superior Quality Innovation Network (LSQIN), MHA Keystone Center and the Michigan Antibiotic Resistance Reduction Coalition (MARR). These organizations are members of the AMS Subcommittee and work with MDHHS regularly on education programs, outreach, webinars and other projects to increase AMS. MARR develops school-age curriculum for antimicrobial resistance educational programs in Michigan and across the country. MARR's Executive Director also leads a dental stewardship initiative designed to target appropriateness in dental antibiotic prescribing. Michigan is one of the few states that focuses on antibiotics in dental practices.
Through these partner collaborations with the SHARP Unit, antibiotic prescribing practices in Michigan will continue to improve. If you have any questions or are interested in collaborating on a project with the MDHHS SHARP Unit, please contact Anne Haddad, antimicrobial stewardship coordinator, (517) 284-4944.