Skip to main content

Northwell stewardship program helps prevent antibiotic drug resistance

The Healthcare Association of New York State (HANYS) has awarded its 2018 Pinnacle Award for Quality and Patient Safety to Northwell Health. The prestigious award, from New York State's only statewide hospital and continuing care association, recognizes the achievements of Northwell's antimicrobial stewardship program in reducing unnecessary antibiotic use and lowering the risk of potentially deadly infections associated with resistant organisms and the aggressive pathogen called Clostridium difficile (C. diff).
"Antibiotic resistance is a major problem in health care today," said Mark Jarrett, MD, Northwell Health's chief quality officer and associate chief medical officer. "We're losing antibiotics that once were effective in treating infections, and people are dying as a result – about 23,000 people a year in the United States die from drug-resistant bacteria, and about 14,000 die from C. diff. Our organization-wide antimicrobial stewardship program was developed to answer that threat."
From 2016 to 2017, the program reduced the total number of days that patients across Northwell were on antibiotics ("antibiotic days") by 9,318. Antibiotic days for five targeted high-use, high-cost antibiotics decreased by 19,231. Of critical importance, the C. diff standardized infection ratio (SIR), a measure used to track health care-acquired infections, decreased by 18.52 percent across nine of the health system's acute-care facilities and Cohen Children's Medical Center.
Northwell's program, The Path of Least Resistance, is aligned with the US Centers for Disease Control and Prevention's campaign to prevent antimicrobial resistance, and with The Joint Commission and Centers for Medicare and Medicaid Services' (CMS) antimicrobial stewardship standards for hospitals, nursing care centers and ambulatory care.
The program is led by a multidisciplinary team that includes a clinical pharmacist, physicians, nurses, microbiologists and specialists in infection prevention, technology and quality. The team developed guidelines for prescribing clinicians and pharmacists, which include indications for antimicrobial medication as well as how long the drug should be used, said Donna Armellino, RN, DNP, the health system's vice president for infection prevention. Particular emphasis was put on frequently prescribed antibiotics and conditions that are commonly treated with antibiotics.
"Antimicrobial stewardship is a patient safety issue," said Dr. Armellino. "We developed a system that prompts the regular reassessment of antibiotic prescriptions across the health system to make sure that the right antibiotic is delivered to the right patient at the right time and the right dose for the right duration."
In addition to developing and communicating guidelines for antibiotic use, the program formalized a greater role for pharmacists in ensuring appropriate antibiotic use, published a monthly antibiotic performance report and a quarterly financial report on antimicrobial utilization, and devised patient education tools on the topic of safe and effective use of antibiotics, among other activities.
HANYS established the Pinnacle Award for Quality and Patient Safety in 2001 to celebrate significant achievements by members in the areas of quality improvement and patient safety. The program recognizes and encourages broad dissemination of successful quality improvement and patient safety initiatives.
# # #
About Northwell Health
Northwell Health is New York State's largest health care provider and private employer, with 23 hospitals, 665 outpatient facilities and more than 18,500 affiliated physicians. We care for over two million people annually in the New York metro area and beyond, thanks to philanthropic support from our communities. Our 66,000 employees – 16,000-plus nurses and 4,000 employed doctors, including members of Northwell Health Physician Partners – are working to change health care for the better. We're making breakthroughs in medicine at the Feinstein Institute for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Graduate Nursing and Physician Assistant Studies. For information on our more than 100 medical specialties, visit
Lisa Davis
Go to top