1331. OPAT: Developing a Patient Tracking Tool to Improve Quality and Safety Across the Care Continuum
Session: Poster Abstract Session: Clinical Practice Issues
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Dhanireddy Beieler OPAT ITHS ID WEEK POSTER 10192016FINAL.pdf (2.2 MB)
  • Background: Prolonged hospitalizations for severe infections including bacteremia, endocarditis, and osteomyelitis requiring intravenous (IV) antibiotics have increased the demand for outpatient parenteral antimicrobial therapy (OPAT) programs. Optimal transition of care from inpatient to outpatient requires much coordination. Through an innovative approach that utilizes existing resources, and development of a tracking tool, we created a multifaceted OPAT bundle to improve patient identification and selection, coordination of care, and allow for program evaluation to improve patient safety and quality of care.

    Methods: In May 2015, we created a computerized patient tracking and reporting tool. Utilizing the informatics consulting services of the University of WashingtonÕs (UW) Institute for Translational Health Services (ITHS) and REDCap, a data collection tool, we created an application and associated workflow for OPAT:

    1) Capture patients for whom an IV line was ordered and appropriate for OPAT

    2)  Manage patients using REDCap and UW Clinical Data Repository to collect clinical patient information from the electronic health record (EHR)  

    3) Enter outside lab results manually into REDCap

    4) Produce formatted text reports for the EHR, and

    5) Track rates of treatment completion, readmissions, and adverse events.

    Results:

    To date, we have identified 688 OPAT episodes 1/1/2015 – 4/30/2016.

    Based on chart review/abstractions, overall 30-day readmission rate is 20% (139/688), with 54% related to OPAT (Table 1). 

    Conclusion: With the collaboration of a multidisciplinary team, we developed an OPAT tracking and reporting system by leveraging information technology resources. This system allows the OPAT team to manage patients and efficiently identify opportunities for process improvement, such as improving follow-rates, decreasing OPAT related admissions, and decreasing overall LOS.

    Table 1

    Total OPAT episodes

    n = 688

         Homeless

    112

    Readmissions total

    139

            Readmissions in homeless

    32

            Readmissions due to  OPAT

    75

    Median Age (years)

    53

    Male

    460

    White

    506

    African American

    84

    Other Race

    67

    Median Length of Stay (LOS) total (days)

    10.35

    Median LOS Homeless

    11.24

    Location

         Seattle

    209

         King County (not Seattle)

    93

         Other counties

    346

         Out of WA state total

    40

    Shireesha Dhanireddy, MD1, Alison Beieler, PA-C2, Anneliese Schleyer, MD1, R. Anthony Black, MA3, Steve Senter, BS4 and Amy Good, PhD4, (1)Medicine, University of Washington, Seattle, WA, (2)Infectious Disease Clinic, Harborview Medical Center, Seattle, WA, (3)Information Technology Services, University of Washington, Seattle, WA, (4)Institute of Translational Health Sciences, University of Washington, Seattle, WA

    Disclosures:

    S. Dhanireddy, None

    A. Beieler, None

    A. Schleyer, None

    R. A. Black, None

    S. Senter, None

    A. Good, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.