Samaritan Health Services’ antimicrobial stewardship team shares how using the Firstline library, analytics and in-app notifications expands the reach of their small ASP team to engage providers across the breadth of the five-hospital health system.

Hello! To begin, please tell us a little about your roles in Antimicrobial Stewardship at Samaritan Health Services.

Adam Brady: I am the chair of the antimicrobial stewardship committee at Samaritan Health Services. The committee oversees stewardship operations at five hospitals and is based at the regional medical center.

Ryan Moore: I am the co-chair of the antimicrobial stewardship committee at Samaritan. Alongside Adam and the other committee members, I assist with development of institutional guidelines and antibiograms, engage with providers in direct patient care as well as track and publish our program’s intervention and publish our antimicrobial use reports. Most recently I have been working to further integrate our ASP with our Quality Improvement and Infection Prevention programs.

What would you say are the key components of the stewardship program at Samaritan Health Services?

AB: The key components of the program are twice weekly prospective audit and feedback, where pharmacists across the Samaritan system present cases to an infectious disease physician and real-time feedback is given to inpatient teams. There is also quality improvement work and a good working relationship with the laboratory to bring on new diagnostics to enhance antimicrobial stewardship.

RM: Additionally, the recent implementation of Firstline has given our program the ability to expand accessibility of the program to providers and to develop standardized institutional guidelines and monographs

Samaritan Health Services is one of the first organizations in Firstline to create a guideline for Monkeypox. Can you please tell us about the process, and considerations you had for creating the guideline?

AB: Prior to going live with Firstline, I had sent out 1-2 page primers with information about monkeypox (how to recognize it, how to order tests, etc.). When we went live with Firstline we realized that having this information easily accessible (either on the web or on the app) was a much better way to rapidly inform our clinicians about the outbreak. Instead of sending out Word documents we can now easily inform staff when vaccination criteria change by sending out a notification on the app. We also link to Firstline directly from our stewardship website.

Samaritan Health Services Monkeypox Guideline in Firstline app

How is your ASP team promoting the use of the infectious disease guidelines among your providers?

AB: We are still in the early stages of going live with Firstline, but so far we have seen pretty robust uptake and feedback has been overwhelmingly positive. 
We are using printed materials and an email campaign to promote use of our guidelines.

"We are a small program (staff wise) so having a resource like Firstline is very valuable to us. It allows us to rapidly develop new guidance and also customize guidelines from a library of other institutions."
- Dr. Adam Brady, Samaritan Health Services.

What role can Firstline play in building a culture of antimicrobial stewardship at Samaritan Health Services?

AB: One of the best things about Firstline is the ease in which we can get our custom recommendations and guidelines out to clinicians. While very few people know how to access the stewardship intranet site, many clinicians have now heard of Firstline and know that is where they can go to access important resources like treatment guidelines and the antibiogram.

RM: In addition, Firstline has created new avenues through which our ASP can now communicate with and engage providers across the breadth of the health system.

Before we finish, what else should we know about your antimicrobial stewardship program or future initiatives?

AB: We are a small program (staff wise) so having a resource like Firstline is very valuable to us. It allows us to rapidly develop new guidance and also customize guidelines from a library of other institutions.

RM: Our ASP, while having been established over a decade ago, has been given renewed energy and focus over the past year. Firstline’s analytics feature has proven particularly enlightening by providing insight into the guidelines and monographs most commonly referenced by our providers. The ability to filter by location and/or role paves the way for targeted educational opportunities and provides feedback on the utility of some of the program’s efforts.

Read about how Firstline’s library works.

View Samaritan Health Services’ guidelines.

Join Dr. Brady and Dr. Moore and contribute to the ID discussion on Firstline Community.