healthcare-associated infections (HAI) Program

CDPH HAI Antimicrobial Stewardship Program (ASP) Honor Roll Part IV - Community Engagement
(Required for Gold Designations)

CDPH ASP Honor Roll Gold Designation logo

Community Engagement Overview

For Gold designation, facilities need to describe a current and ongoing partnership including activities within the most recent one year preceding the application deadline date.
This partnership should demonstrate work with community healthcare providers (e.g., hospitals, outpatient clinics, skilled nursing facilities) or local collaborations/chapters (e.g. healthcare associations, dental associations, Association for Professionals in Infection Control and Epidemiology, Health Services Advisory Group, etc. ) with emphasis on antimicrobial stewardship.
In general, partner organizations should not be affiliated with the applicant’s organization (e.g., assisting an outpatient facility within the same organization is usually not sufficient, though may be considered on a case-by-case basis if staffing and leadership are separate).
Partnerships should go beyond simply providing education, sharing institutional guidelines , or providing good transitions of care. We are looking for true engagement with community partners with the overall goal of improving antimicrobial stewardship, prescribing practices, and antimicrobial use in the local community.
Engagements are expected to be sustainable and ongoing. Engagements still in the “planning phase” may be too early for submission.
Please ensure all answers are complete in the application. Please provide enough detail for us to evaluate the quality of the community engagement.
Although not required, applications are aided by tracking stewardship outcomes in the organization with which you partner. Such outcomes could include antimicrobial use related to a stewardship intervention, improved use of appropriate diagnostics, or evidence of improved adherence to the core elements of antimicrobial stewardship.

Renewal Applications

You will be prompted in the online application to select either a new or previously submitted community partnership.
If you are renewing a previously submitted partnership, please include details on the ongoing need and benefit of the partnership. Please also provide updates on activities, interventions, and results, especially those in the most recent year.
Renewed submissions should demonstrate new and ongoing active work to improve antimicrobial stewardship in the partner organization(s).
Please answer all questions.

Examples of Community Engagement

Regional collaboratives such as a county collaborative of acute care facilities and nursing homes that frequently share patients. Work could include sharing antimicrobial use and resistance data and developing interventions focused on improving antimicrobial use and reducing resistance in the local community (such as implementing urinary tract infection diagnosis and treatment guidelines). Additional partners could include the local health department.
Mentoring a limited resource facility or facilities such as a critical access hospital or a local skilled nursing facility. Limited resource facilities may not have an antimicrobial stewardship pharmacist and/or infectious diseases provider to help them improve antimicrobial use. Partnerships may include providing ongoing assistance to create stewardship initiatives and track success, regularly reviewing active antimicrobial courses for appropriateness, or providing other types of assistance depending on what the facility needs. Such assistance should go beyond one-time help, improving transition of care, consultation on patients requiring ongoing infectious disease follow up, or solely providing education.
Outreach to local outpatient clinics and/or medical groups to improve outpatient prescribing in the local community. Examples may include having partner groups and providers sign and publicly display posters demonstrating a commitment to not prescribing unnecessary antimicrobials, reviewing prescribing data and generating provider-specific antimicrobial use reports with peer comparison, and updating order sets to improve diagnosis and guideline prescribing.

Examples of Community Engagements: Not Acceptable versus Acceptable

Examples of Not acceptable:	What would be accepted instead:
Partnering with a “sister” facility in your health system to consolidate or coordinate your antimicrobial stewardship program and/or interventions. Reason: The goal of community engagement is to provide and improve antimicrobial stewardship in the broader community.	Mentorship to a lower resource facility such as a critical access hospital or long-term acute care facility with provision of ongoing stewardship support.
Providing a one-time webinar or presentation to a facility with limited resources. Reason: We are looking for sustained involvement in community engagement partnerships beyond solely providing education.	Providing ongoing support to a lower/limited resource facility, including education and participation in regular meetings to discuss and implement stewardship interventions.
Developing or improving transition of care communication between your hospital and a skilled nursing facility. Reason: Transition of care communication should be standard.	Providing regular review and feedback of active antimicrobials or implementing an intervention to improve diagnosis and treatment of common infections (e.g., urinary tract infections) at a skilled nursing facility with whom you share patients.
Extending antimicrobial stewardship program interventions to your facility’s emergency department. Reason: Working with another department within your facility is not the intent of community engagement.	Working with local urgent care centers or outpatient clinics in your area to provide antimicrobial stewardship support. Note: If these facilities are part of your health system, they should generally not have the same clinical staff or leadership as the hospital. Situations will be evaluated on a case-by-case basis.