Firstline Client Stories

“Unlike Field of Dreams, just because we build it does not mean they’ll come. There are many clinical decision resources and knowledge bases available for infectious diseases and antibiotics and often these are positioned directly in our EHR’s. Unfortunately, these resources do not always account for local nuances such as formulary, local antibiograms, or the demographics of your catchment area. Firstline plays an important role here by allowing us to meet our prescribers, pharmacists, nurses, and other clinical staff where they are. Specifically, by providing a knowledge base platform that can be accessed online and at bedside via mobile phone. This has allowed us to place our guidelines in preferential positions over alternatives, easily share links to specific guidance, and – via mobile push notifications – quickly communicate changing guidelines and new developments. The latter has been particularly valuable during the COVID-19 pandemic.”

“Building on the success of prior syndrome-specific interventions and the ease of accessing our locally derived guidelines in the Firstline app, we have been able to take antimicrobial therapy to a new level allowing safe de-escalation of broad-spectrum antimicrobials optimizing patient care.”

“We previously had a challenging time with being able to educate providers and appropriately guide them for 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..”

“Firstline has really helped us promote best practices in antimicrobial prescribing across both hospital sites, and expand the content to be relevant to clinicians working in the outpatient setting as well.”

“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. 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.” - AB

“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. 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.” - RM

“We considered that Firstline had Android and iOS versions. This made it a robust partner for our implementation. We also had concerns about the cost of internet data in Nigeria, so it was important that the Firstline app is available offline. The team at Firstline was very accommodating and easy to work with. Their suggestions helped to make our guidelines better and more relevant to our setting.”

“I like to think of our guidelines as evolving, and use them as a teaching tool. I ask people to download Firstline on their phones so that we can review guidelines together, and sometimes even use it to show patients that you need to have symptoms to get an antibiotic.”

“On the wards when we do handshake stewardship, if someone tells me they don’t understand our guideline on sinusitis, for example, we’ll go to that section in the Firstline app and I’ll find out what part they don’t understand. Then, with them, I’ll change the wording of the guideline to make it more understandable. I’ll go back to my desk, make the changes in the Firstline platform and it will be instantly updated and more clear to the user. The guidelines get better and better as we go on.”

“People are more aware of diagnostic criteria and what to order as there is a small section at the top of each guideline on this. I now rarely see a duplicate spectrum of antibiotics which is better for patient care. I see that people are more comfortable with amoxicillin challenges since the app has the protocol. Any ED can now do this. In short, the Firstline app has become part of our culture of patient safety and good prescribing.”

One of the most innovative ways the IWK is carrying out the stewardship program is through Firstline, a digital app that Kathryn Slayter, along with a collaborative team of colleagues, developed. Firstline was the first IWK-branded app to be created and is the first antimicrobial stewardship app created by a women and children’s hospital in Canada. Firstline contributes to improved adherence to local guidelines and appropriate therapy.

“The large amount of my efforts is centered mostly [on] one facility, due to the fact that I just don’t have the ability to actually get to that many beds, [or] with any large degree of impact. Hence why we came up with getting [Firstline] on board- it’s a leverage tool.”

“The biggest meter for us is, we know that the average interaction time is about 28 seconds on our app… and we never have more than two and a half minutes. That’s not long at all, and for us that is a huge success. We very purposely developed ours to stick to a four to six click rule, so you should be able to get 90%-95% of information within four to six clicks.”