Antimicrobial Resistance CQUIN 2019-2020 Improving antibiotic prophylaxis for elective colorectal surgery & improving the management of lower UTI in older people 27 th February 2019 Emma Cramp NHS Improvement – Quality Improvement Advisor [email protected]@EmmaCramp
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Antimicrobial Resistance CQUIN 2019-2020€¦ · Antimicrobial Resistance CQUIN 2019-2020 Improving antibiotic prophylaxis for elective colorectal surgery & improving the management
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Antimicrobial Resistance CQUIN 2019-2020Improving antibiotic prophylaxis for elective colorectal surgery & improving the management of lower UTI in older people27th February 2019
Emma CrampNHS Improvement – Quality Improvement [email protected] @EmmaCramp
• 2018-2019 Antimicrobial Resistance CQUIN • Background • Urinary Tract Infections• Surgical Prophylaxis• Antibiotic Consumption• Where to find information for 2019-2020 CQUIN• Key areas to focus on to help achieve CQUIN 2019-2020
• Scotland implemented a surgical prophylaxis indicator• From April 2011 to September 2013• Target of >95% of sampled cases given a single dose of a policy compliant
antibiotic for elective colorectal patients• Median compliance for single doses was found to be 98% and 93%
compliance with antibiotic choice• 100% of boards submitting data achieved ≥95% compliance with the
measure “Single Dose” and 70% of the boards submitting data achieved ≥95% compliance with the measure “Antibiotic Choice Compliant with Policy”.
• Improving the diagnosis and management of lower UTI in older people
• Move towards simplification of the CQUIN indicators
• Antibiotic prescriptions for adult patients treated for lower urinary tract infections to be compliant with NICE guidance (NG109) and PHE Diagnosis of UTI guidance in terms of diagnosis for older people
• Data collection tool from NHSI/PHE and stakeholders
• Submit quarterly data to PHE via the online portal
• Minimum (60%) and maximum (90%) thresholds to receive payment
• Minimum level defines 0% payment and maximum defines 100% payment
• Payment for performance between these levels will be smoothly graduated without the need for defining partial payment thresholds. For example, a performance of 80% would result in ((80-60)/(90-60))*100 = 66.6% payment
• Improving appropriate antibiotic surgical prophylaxis in elective colorectal surgery
• Antibiotic surgical prophylaxis prescribed for colorectal surgery to be a single dose (or further doses if >1.5L blood loss, infection/contamination found during surgery or prolonged length of surgery) and prescribed in accordance to local antibiotic guidelines.
• Data collection tool from NHSI/PHE
• Submit quarterly data to PHE via the online portal
• Auditing two data fields: number of doses and antibiotic choice in line with local hospital guidance
• Both indicators: Recommendation for junior doctors or ward pharmacists to collect the audit data to allow antimicrobial teams to focus on QI
• Carbapenem and Access category indicators have been removed to simplify the CQUIN
• Total antibiotic consumption target has moved to the NHS Standard Contract• Commissioners will be provided with information in order to ensure acute trusts
remained focused to reduce antibiotic prescribing• Baseline: Calendar year 2018• Target: 1% reduction over the financial year 2019/2020
• PHE will automatically use consumption data from RxInfo Define® through data sharing agreements between NHS acute trusts and PHE.
• NHS acute trusts that believe there are discrepancies between RxInfo Define®
data and data from internal pharmacy dispensing systems may submit data directly to PHE