CDC highlights Michigan CQI response to COVID-19 antibiotic overuse

By: Jaime Meyers

Coronavirus illustration

More than half of Michigan COVID-19 patients received unnecessary antibiotics in the early days of the pandemic, but that number decreased significantly due to a joint effort by the Michigan Collaborative Quality Initiatives (CQIs).  The Centers for Disease Control and Prevention (CDC) has taken notice and featured the CQI work in a national stewardship report, Antibiotic Use in the United States, 2021 Update: Progress and Opportunities.”

In March 2020, members of the Michigan Hospital Medicine Safety Consortium (HMS) pivoted their Antimicrobial Use Initiative, which works to ensure patients with pneumonia or positive urine cultures are not given inappropriate antibiotics, to establish the Mi-COVID19 Initiative. Nearly a dozen CQIs joined the effort, including shifting their abstractors to collect data for the Mi-COVID19 Initiative. Utilizing the established CQI data collection structure, the Mi-COVID team was able to create the database in less than a week, a process that often takes months.

“Because of our sepsis work, we already had all the hospital partners in the room including hospitalists, critical care, infectious diseases, pharmacists, and the emergency department,” said HMS Program Manager Elizabeth McLaughlin. “We had systems in place to easily collaborate and disseminate the information. It helped that they already knew who we were and that we were trustworthy.”

Equipped with this distinctive and valuable data, the Mi-COVID19 Initiative held regular webinars attended by hundreds of providers from across the state to share information, identify areas of concern, and develop best practices while bringing together a community of stressed health care providers who were facing unprecedented challenges. Findings were also shared through a series of fast-tracked scholarly publications to ensure providers across the country and around the world had access to their recommendations.

Additionally, the Mi-COVID19 Initiative formed an interdisciplinary executive committee with leadership from the other CQIs, Blue Cross Blue Shield of Michigan (which funds the CQIs), the Michigan Health & Hospital Association, and representatives of health systems from across the state to ensure they were using the data in the most effective way possible.

“We didn’t want HMS to be the only decision makers, especially when we had such great partners,” said McLaughlin. “We had providers from around the state including one who was one of the first physicians to be hospitalized with COVID-19, so we had a patient perspective too.”

In less than a year, the joint effort led to a 20% decrease in patients who received inappropriate antibiotics.

“You have to be able to give the data to show hospitals where they can improve,” said McLaughlin. “We were able to share which hospitals are doing well and why quickly. That’s what the CQIs are built for. It’s our mission.”

Jaime Meyers is a communications manager at the Institute for Healthcare Policy and Innovation at the University of Michigan.