Firstline works with stewardship teams every day to create more impact for their guidelines and deliver real-time guidance for providers. But how does that happen exactly? We recently interviewed two pharmacist leads at St. Dominic’s Hospital, Dr. Jamie Wagner and Dr. Andrew Watkins about their onboarding experience with Firstline and to get a deeper understanding of their ASP objectives.
Can you tell us about your role in antimicrobial stewardship at St. Dominic’s?
AW: I serve as the pharmacist leader for antimicrobial stewardship, and Jamie is our other ID pharmacist that assists with developing initiatives, reviewing patients, and steering the program.
What are some key components of St. Dominic’s ASP, and how does it support the health system’s overall goals and priorities?
AW: The key components of our ASP include our executive/steering committee meeting monthly and our larger ASP committee meeting every 4-6 months. The executive committee consists of our ASP pharmacists and physician, infection preventionists, and microbiology lab representative and is tasked with establishing the program’s direction and day-to-day operations. The full ASP committee contains a larger representation from quality, nursing, IT, and medical staff and serves as a guiding body and avenue for the dissemination of ASP information back to members’ respective teams. From an operational standpoint, our ASP uses Firstline clinical decision support software to facilitate prospective audits and feedback based on patient-specific factors (culture results, certain antimicrobials, etc.). We also work collaboratively with other facilities within our health system to implement ASP initiatives, protocols, and guidance documents.
How do you currently teach stewardship to your providers?
JW: We currently have stewardship education during new employee orientation, as well as in-services, emails, and newsletters. Firstline allows us to have real time access to our providers by allowing blast messages, such as when antibiotics are in shortage and how we plan to manage them.
What inspired you to partner with Firstline, and what do you hope to achieve through this collaboration?
JW: My amazing friend and colleague, Julie Justo, tweeted about using Firstline at her facility. I asked her to explain more about it and immediately knew that Firstline would help our stewardship efforts and prescribers at St. Dominic’s. That’s when I reached out through Firstline’s website to find out more information and get in touch with someone.
How would you describe the onboarding process with Firstline’s Clinical Content Team to an institution considering partnering with Firstline?
JW: The onboarding process with Firstline is super simple! The team there have been amazing communicators and ridiculously efficient in uploading and formatting all the information. They’ve also been very supportive and quick to respond when I’ve had questions or needed help. It’s been such a positive experience working with all of them!
Can you describe your experience working within the Firstline Content Management System?
JW: Working within the Firstline Content Management System has been very user-friendly. For someone who is only mildly technology-literate, they really did a great job keeping the end user in mind. As always, the team was there to answer any questions if I couldn’t figure something out.
In which specific areas has Firstline been most helpful, and how has Firstline’s support impacted your work in real time?
JW: Firstline has been very helpful in aiding us in disseminating our antimicrobial stewardship guidelines and antibiogram information. We previously had a challenging time with being able to educate providers and appropriately guide them in managing common inpatient infections. Firstline has allowed us to offload a lot of that burden by being easily accessible on everyone’s phone without needing the internet or a secure login to see the information. That’s been key for us in our daily workflows by allowing us to spend our time on more challenging cases.
What have been some of the biggest surprises or challenges you’ve encountered while working on this project with Firstline, and how have you addressed them?
JW: For us, the biggest challenge was getting local guidelines approved in time for launch. We tried to have our own guidelines, not just for The Joint Commission accreditation purposes but also so our prescribers could have input on recommended regimens. Our workaround for guidelines we don’t yet have has been integrating guidelines from other hospitals within the Firstline network. I can’t tell you how invaluable that Library has been for allowing us not to recreate the wheel. I feel like we can all aid each other in that manner.
What’s next for your ASP at St. Dominic’s?
JW: Our ASP will continue to focus on developing more institution-specific guidelines and optimizing patient care through other initiatives, such as appropriate dosing in different populations. As we demonstrate local cost savings using Firstline, we plan to expand its use to the other hospitals within our health system.