Outpatient Parenteral Antimicrobial Therapy (OPAT) Monitoring in the Electronic Health Record (EHR)

Purpose: To avoid admissions, reduce the length of stay, and provide appropriate management of care from inpatient to outpatient for OPAT patients. Opportunities were noted in the EHR to monitor patients who need outpatient parenteral antimicrobial therapy through documentation, reporting, and follow-up patient outreach encounters. Communication was also improved between inpatient providers, pharmacists, and outpatient providers and nurses. Baseline data showed 100% outpatient follow-up of these patients.

Description: A collaborative effort with infectious disease physicians and APNs, pharmacy, outpatient providers, and nursing, as well as information technology and medical informatics, was used to explore solutions to help monitor these patient efficiently. OPAT meetings were held weekly with the team to design a viable solution where evidence-based practice drove the technology for OPAT workflows and documentation. Standardized processes were developed including:
• OPAT inpatient infectious disease provider note
• OPAT discharge order set
• In-basket notifications of new OPAT patients enrolled in the program
• Real-time reporting of current OPAT patients which displays their admission date, discharge date, problem list, antimicrobial medication, lab results, last patient outreach encounter, and when the next patient outreach encounter should be held
• Streamlined OPAT flowsheet documentation in the patient outreach encounter

Evaluation/outcome: Data demonstrated an increase in follow-up from 58% to 100% of OPAT patients. Utilizing a collaborative effort to implement standardized workflows has proven to be a successful methodology for improving the monitoring of OPAT patients. This organization was able to decrease the length of stay and decrease admissions through successful follow up. Continuous evaluation of informatics processes is needed to update and support the monitoring of OPAT patients, which is vital to the patient’s quality of care being provided.

Learning Outcome: After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.