Latest / The SHEA Podcast / Prevention Collaboratives: Hospitals and Health Departments Working Together, Part One

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Prevention Collaboratives: Hospitals and Health Departments Working Together, Part One · The SHEA Podcast

• 0:07
  SPEAKER_03: Welcome to Shay's Podcast.
• 0:09
  SPEAKER_03: I am Dr.
• 0:10
  SPEAKER_03: Maria Walters and I lead the antimicrobial resistance team in CDC's Division of Healthcare Quality Promotion.
• 0:17
  SPEAKER_03: I'm also the co-chair of Shay's Public Health Task Force.
• 0:20
  SPEAKER_03: I'm pleased to serve as today's moderator for the first of two podcasts focusing on hospitals and health departments working together to implement prevention collaboratives.
• 0:30
  SPEAKER_03: Before we get started, I'd like to introduce you to today's speakers.
• 0:34
  SPEAKER_03: Dr.
• 0:35
  SPEAKER_03: Lauren Bealey, Farm D BCPS, BCIDP, is the antimicrobial stewardship pharmacy lead at the Colorado Department of Public Health and Environment.
• 0:46
  SPEAKER_03: As a stewardship pharmacist with the State Health Department, her role focuses on guidance and support of appropriate antibiotic use across the spectrum of health care in Colorado.
• 0:58
  SPEAKER_03: Next, Dr.
• 0:59
  SPEAKER_03: Michael Bozella, DOMS, is a pediatric infectious disease physician and assistant professor at the University of Colorado School of Medicine and Children's Hospital Colorado.
• 1:11
  SPEAKER_03: He has been working as physician lead of the Colorado Antimicrobial Stewardship Endeavor in partnership with the Colorado Department of Public Health and Environment since the project started in 2021 in order to help develop stewardship programs across the state.
• 1:27
  SPEAKER_03: Finally, Dr.
• 1:28
  SPEAKER_03: Joanna Demo, DO, is a Pediatric Infectious Diseases Fellow at the University of Colorado School of Medicine and Children's Hospital, Colorado.
• 1:37
  SPEAKER_03: She has been part of the collaborative with CDPHE since the start of fellowship, and her main project involves improving antibiotic use throughout Colorado through the implementation and dissemination of a free mobile app.
• 1:51
  SPEAKER_03: First line.
• 1:53
  SPEAKER_03: Thank you so much to our speakers and to our audience for joining us today.
• 1:58
  SPEAKER_03: As I mentioned, this is going to be the first of two podcasts about prevention collaborative.
• 2:03
  SPEAKER_03: We hope these case studies will serve as inspiration for other similar partnerships between hospitals and health departments in order to address pressing infection control and antibiotic resistance and antibiotic stewardship issues.
• 2:16
  SPEAKER_03: To start, Lauren, could you orient our listeners to the Colorado Antimicrobial Stewardship Endeavor or CACE?
• 2:24
  SPEAKER_02: Sure.
• 2:24
  SPEAKER_02: Thank you so much, Mariah.
• 2:26
  SPEAKER_02: So the Colorado Antimicrobial Stewardship Endeavor, or we refer to it as a CACE, is a partnership between the Health Department, which is the Colorado Department of Public Health and Environment, and Children's Hospital Colorado.
• 2:39
  SPEAKER_02: It's designed to enhance stewardship practices across Colorado hospitals.
• 2:44
  SPEAKER_02: Michael's going to talk a little bit about how it got started, but we launched in 2021 as a method to provide mentorship, resources, and evidence-based tools to support our healthcare professionals in implementing the core elements of stewardship.
• 2:59
  SPEAKER_02: We try to foster collaboration and knowledge sharing to improve patient outcomes and reduce antimicrobial resistance across our Colorado hospitals.
• 3:09
  SPEAKER_03: Great, Lauren.
• 3:10
  SPEAKER_03: Thanks for that overview.
• 3:11
  SPEAKER_03: And Michael, can you tell us more about how the idea for the Cates Collaborative came about?
• 3:16
  SPEAKER_00: Sure.
• 3:17
  SPEAKER_00: So as a sheriff, everybody on this call knows or recognizes that antimicrobial resistance is a major threat to public health around the world.
• 3:26
  SPEAKER_00: And to help combat some of this, the CDC came up with great guidelines or the core elements of hospital antimicrobial stewardship back in 2014 with updates in 2019.
• 3:37
  SPEAKER_00: It was around this time one of our prior infectious disease fellows here at Colorado thought to take a harder look at like, okay, so we have these great guidelines.
• 3:45
  SPEAKER_00: How are they actually being used or employed in hospitals across the state?
• 3:50
  SPEAKER_00: So actually, working with some mentors, both at Children's Hospital Colorado, as well as at the CD PHE, he designed a mixed method survey looking at acute care hospitals and critical access hospitals here in Colorado.
• 4:01
  SPEAKER_00: And the purpose of this assessment was really to focus on how are hospitals doing?
• 4:06
  SPEAKER_00: How are they tracking with their actions?
• 4:08
  SPEAKER_00: How are they handling their data tracking?
• 4:09
  SPEAKER_00: And how are they handling their reporting back to their prescribers as it pertains to these core elements?
• 4:15
  SPEAKER_00: And it was really through this survey, something early that came out in 2021, that while overall adherence was excellent, when you really took a fine fine-toothed comb to the situation or looked a little bit closer, that adherence really dropped when stricter criteria were used.
• 4:31
  SPEAKER_00: And also as part of the survey, he started to find out some of those barriers that these hospitals were encountering as they were trying to develop these programs adhering to these strictures.
• 4:41
  SPEAKER_00: So it's really out of this survey and finding out some of these obstacles and hurdles and what was actually going on in the state, we thought, hmm, maybe we can help.
• 4:49
  SPEAKER_00: So Case was really born out of this next step.
• 4:51
  SPEAKER_00: Now that we have this baseline information, we have this relationship established with CDPHE.
• 4:56
  SPEAKER_00: Let's see where we could go.
• 4:58
  SPEAKER_00: How do we address the needs of our hospitals, both acute care and critical access across our state?
• 5:04
  SPEAKER_03: That's great, Michael.
• 5:05
  SPEAKER_03: So really you used this mixed methods study that sounds like it was already a collaboration between public health and the hospital to identify what was happening, what the gaps are, what the barriers are.
• 5:18
  SPEAKER_03: And then you really designed your collaborative to fill in the gaps.
• 5:22
  SPEAKER_03: And so, Lauren, can you tell us about the role of the health department in developing the collaborative and sort of taking us from this initial survey to the program that you have today?
• 5:35
  SPEAKER_02: Absolutely.
• 5:36
  SPEAKER_02: I think one of the things that was exciting about this survey is that it not only assessed the core elements, which we do every year in our hospitals, but it also asked, what do you need?
• 5:46
  SPEAKER_02: Where are what are your barriers to implementing the core elements?
• 5:50
  SPEAKER_02: And we were able to identify several.
• 5:53
  SPEAKER_02: These included things like educational resources, data analysis assistance, stewardship expertise, and then some of the project that Joanna is going to talk more about, which is clinical care guidelines, including those for pediatrics.
• 6:08
  SPEAKER_02: So does every hospital have to create their own guideline from scratch, or can we support them and help them with that?
• 6:14
  SPEAKER_02: So we identified this need for academic centers and public health departments to assist our community hospitals in these specific four areas.
• 6:23
  SPEAKER_02: And that's how we began designing our initiatives in case.
• 6:27
  SPEAKER_02: The other thing I wanted to point out is that when it comes to stewardship at the health department level, we have the ability to provide outreach to partners and data analysis resources to help implement stewardship initiatives.
• 6:40
  SPEAKER_02: One of the things that I love is that we have a unique role in connecting these partners and providing things like benchmarking that can typically only occur in a healthcare system.
• 6:50
  SPEAKER_02: But because we can work with all the hospitals in our state, we're able to provide some of that support in data analysis and expertise.
• 6:58
  SPEAKER_02: And then we have a great relationship with Children's Hospital through CACE that also allows to have one-on-one coaching and workshops that we'll talk a little bit more about as well.
• 7:08
  SPEAKER_03: Thanks, Lauren.
• 7:08
  SPEAKER_03: And Michael, can you tell us a little bit more about those roles of Children's Hospital?
• 7:14
  SPEAKER_00: Totally.
• 7:14
  SPEAKER_00: And so, like Lauren's been hitting on, this really has been a partnership.
• 7:18
  SPEAKER_00: So a lot of the resources that the CDPHE has been providing or adding to this, we couldn't do this project without them.
• 7:24
  SPEAKER_00: And so, really, where they have the infrastructure and the background, the ability to like kind of reach out to all these hospitals, Children's Hospital is really providing more of that boots on the ground, clinical expertise when it comes to stewardship.
• 7:36
  SPEAKER_00: The participants from Children's Hospital, Colorado are all members of our antimicrobial stewardship program.
• 7:40
  SPEAKER_00: Here at Children's Hospital, we practice a handshake model, but we also have experience in other forms of those priority interventions for stewardship.
• 7:49
  SPEAKER_00: So, with our more clinical lens, we're able to work with the CDPHE with being informed by the Mixed Methods Survey to really develop these targeted educational interventions.
• 7:59
  SPEAKER_00: So the workshops that Lauren has been alluding to, the initial topics that were covered were all in the first year of our cycle, all really came out of those CDC core priority elements.
• 8:09
  SPEAKER_00: And over the past several years, throughout some of our other survey work, we've really continued to develop and expand these workshop series based on what we're hearing back from our participants, really kind of taking this all through that clinical lens, thinking, okay, there's this great information, but let's boil this down and provide our facilities with this, these clinical pearls.
• 8:28
  SPEAKER_00: How do I actually implement this?
• 8:30
  SPEAKER_00: How do I do this?
• 8:31
  SPEAKER_00: And that same token, too, we also help with those one-on-one coaching sessions.
• 8:35
  SPEAKER_00: So a lot of the members of our team have a lot of expertise or practice themselves in kind of looking at this data.
• 8:41
  SPEAKER_00: Okay, we have this, you can collect all the days of therapy data that you want, but without that ability to really sit and look at it and analyze it, it's kind of like, where do I go from here?
• 8:49
  SPEAKER_00: And so that's one of those services that our team is able to provide, particularly with some of our members like Dr.
• 8:54
  SPEAKER_00: Christine McBrain, who's a fantastic ASP pharmacist, and Dr.
• 8:57
  SPEAKER_00: Sarah Parker, who's one of the forerunners of handshake stewardship, really helping dive in to look at, okay, you guys have this wonderful data.
• 9:05
  SPEAKER_00: Let's talk about what's going on in your hospital.
• 9:07
  SPEAKER_00: And that's what we bring to the table is that that clinical lens.
• 9:11
  SPEAKER_00: And that's one of our major goals with this, like I alluded to, was really making sure that everything that we offer really is directly clinical, clinically applicable.
• 9:20
  SPEAKER_00: All of our offerings are one-on-one coaching sessions, even when we're designing the objectives for our workshops.
• 9:25
  SPEAKER_00: We want our facilities to walk away with something that they can immediately put into practice.
• 9:30
  SPEAKER_00: And we also target this to a wide range of audience members.
• 9:33
  SPEAKER_00: So, yes, we have a lot of physicians and pharmacists that we work with, but we've come to recognize that yes, we have infection preventionists as well as clinical nurses that are all involved in the stewardship processes out there.
• 9:43
  SPEAKER_00: So we're making sure that we kind of keep this broad in terms of our target audience.
• 9:48
  SPEAKER_03: Thanks, Michael.
• 9:49
  SPEAKER_03: That is really helpful to hear about just the breadth of activities.
• 9:52
  SPEAKER_03: And it sounds like the scope of case has expanded over time.
• 9:57
  SPEAKER_03: So I was wondering if Lauren, maybe you could tell us a little bit more.
• 10:01
  SPEAKER_03: The collaborative started in 2021.
• 10:04
  SPEAKER_03: How has it grown over time?
• 10:05
  SPEAKER_03: Michael's told us a little bit about the different activities that have been added over time, recognizing different partners, but can you tell us a little bit more about the numbers and who's involved in the collaborative?
• 10:18
  SPEAKER_02: Absolutely.
• 10:19
  SPEAKER_02: Um so as Michael was mentioning, we provide workshops.
• 10:22
  SPEAKER_02: So we generally do at least four workshops a year.
• 10:25
  SPEAKER_02: And these are held virtually.
• 10:27
  SPEAKER_02: We are lucky enough to get speakers from Colorado as well as from around the country who are experts in these areas.
• 10:34
  SPEAKER_02: So we have workshops and then we offer all of our facilities a virtual or sometimes in-person one-on-one consultation about whatever they're interested in talking about in stewardship.
• 10:47
  SPEAKER_02: So maybe something that they're having struggles with or are interested in learning more about.
• 10:53
  SPEAKER_02: And we can spend that time with them to go over, you know, one of the roles that we have at the health department is we'll go over their AUR data with them, help them understand a little bit more about their trends and antibiotic use.
• 11:05
  SPEAKER_02: Um, and so really trying to take an approach to whatever their pain point is and help them in that one-on-one coaching session.
• 11:12
  SPEAKER_02: As Joanne will talk about, we've now expanded our reach.
• 11:15
  SPEAKER_02: And so we have a series called the Case Collective that is focused on our rural and critical access hospitals.
• 11:22
  SPEAKER_02: I think she's going to talk a little bit more about that.
• 11:25
  SPEAKER_02: And so we just kind of continue to evolve based on the needs of our cohort.
• 11:30
  SPEAKER_02: We began in 2021, as was mentioned, with 17 hospitals.
• 11:34
  SPEAKER_02: And last year we had 42 facilities with a total of 78 participants.
• 11:40
  SPEAKER_02: So it continues to grow over time.
• 11:42
  SPEAKER_02: We're recruiting right now for case 24, 2025.
• 11:46
  SPEAKER_02: So it's been really exciting to see the program grow.
• 11:49
  SPEAKER_02: And also, I think to see the members that we've retained over the years.
• 11:53
  SPEAKER_02: Um, so people continue to have an interest in case and learning about the variety of topics that we present and work with them on throughout the series.
• 12:01
  SPEAKER_03: Yeah, that's really a tremendous expansion in a pretty short period of time.
• 12:06
  SPEAKER_03: And so, Lauren, I'm wondering if you could tell us more about how you've conducted recruitments to engage facilities in the collaborative and if you have any recommendations for others who maybe want to do something similar.
• 12:18
  SPEAKER_02: Yeah, thank you.
• 12:19
  SPEAKER_02: So we contact all of our hospitals in Colorado for recruitment once a year around this time.
• 12:26
  SPEAKER_02: Case generally goes between fall and spring, early summer.
• 12:30
  SPEAKER_02: And so we contact all of them.
• 12:32
  SPEAKER_02: Again, many of our participants are repeat participants from previous years, which we love because we get to see their program continue to evolve and expand.
• 12:42
  SPEAKER_02: I think what is really, really fun for us that we've seen over the years is that we have such a variety of hospitals.
• 12:48
  SPEAKER_02: I know every state has a variety of hospitals for us.
• 12:52
  SPEAKER_02: Um we I was looking at 2023, 2024, and our median bed size was 25 beds, so pretty small, uh, with a range of fewer than 10 beds to almost 700.
• 13:04
  SPEAKER_02: So we have a huge range of participants.
• 13:08
  SPEAKER_02: They probably have a huge range of resources and staff dedicated to stewardship, and their goals around stewardship may vary depending on who they report to and things like that.
• 13:19
  SPEAKER_02: But we're able to provide content that applies to all of them in different ways.
• 13:25
  SPEAKER_02: And I should mention to you that all of our recordings and slides are available on our case website.
• 13:32
  SPEAKER_02: So if there's interest in that, you can see all of the program that we've done since 2021.
• 13:37
  SPEAKER_02: And those are all freely available for anyone who's interested.
• 13:41
  SPEAKER_03: Great.
• 13:41
  SPEAKER_03: Thanks, Lauren, and thanks, Michael, for that really nice overview of CACE and taking us through sort of its its evolution over time.
• 13:50
  SPEAKER_03: And now I'd like to turn to Joanna to hear more about the impacts that you have seen from the CACE collaborative.
• 13:58
  SPEAKER_01: Yeah, thank you.
• 13:59
  SPEAKER_01: So I think the greatest impact of CACE is that we provide Colorado hospitals with mentorship and resources to support their stewardship endeavors.
• 14:10
  SPEAKER_01: And we really have several ways of doing this.
• 14:12
  SPEAKER_01: So Michael and Lauren touched on the workshops and the individual consultations that we provide through CACE.
• 14:20
  SPEAKER_01: We also have a ton of resources on our website that go through that that just provide examples and um ways for hospitals to implement priorities, priorities for the core elements, focusing on action tracking and reporting.
• 14:44
  SPEAKER_01: We also have launched this app called First Line.
• 14:48
  SPEAKER_01: First Line is a free locally developed antimicrobial stewardship and infectious diseases app that was created by Children's Hospital Colorado and also our adult partner, Denver Health.
• 15:01
  SPEAKER_01: And through First Line, we have been able to disseminate evidence-based treatment guidelines that were created from clinical pathways from Children's Colorado and Denver Health that span all healthcare settings and age groups.
• 15:18
  SPEAKER_01: In First Line, we also have information on age-specific antimicrobial dosing and resources for infection prevention and antimicrobial stewardship.
• 15:27
  SPEAKER_01: And these are all present on the app.
• 15:29
  SPEAKER_01: We launched First Line in October of 2023, and we now have over 4,000 users in the state, along with First Line and getting these pathways and guidelines to our Colorado providers.
• 15:45
  SPEAKER_01: We have also developed tools to assist facilities in measuring and reporting their adherence to treatment guidelines.
• 15:53
  SPEAKER_01: And we created these tools specifically for urinary tract infections, pneumonia, and skin and soft tissue infections.
• 16:01
  SPEAKER_01: And these tools are present on our case website, and they're also present through the First Line app.
• 16:07
  SPEAKER_01: And along with these tools, we also started a new project called the Colorado Antimicrobial Resources Education and Pathway Adherence Tools for hospitals, which we just call CarePath for short.
• 16:20
  SPEAKER_01: And this is an initiative where hospitals can take part and have assistance in measuring their adherence and they can receive individualized feedback from our teams and recommendations on how to improve their stewardship practices.
• 16:36
  SPEAKER_01: Additionally, we have also created the case collective, as was mentioned before on the previous survey that our fellow did.
• 16:46
  SPEAKER_01: We noticed that critical access hospitals are the ones that really need the additional support in terms of stewardship resources.
• 16:54
  SPEAKER_01: And this was also reported on the core elements in the NHSN Annual Hospital Survey.
• 17:01
  SPEAKER_01: So Case Collective is an interactive series that promotes peer-to-peer discussion for antimicrobial stewardship strategies specific to resource-limited settings and critical access hospitals.
• 17:16
  SPEAKER_01: We currently have 30 rural and critical access hospitals that participate in these sessions, and these happen quarterly through the CACE collective.
• 17:25
  SPEAKER_03: Joanna, thanks so much for telling us about all of those resources.
• 17:30
  SPEAKER_03: And just a note to our listeners that we do have a link to the case website that we is included with the description of the podcast if folks are interested in accessing some of those case resources that Joanna, Michael, and Lauren have mentioned.
• 17:47
  SPEAKER_03: So just as we close out, um Lauren and Michael, can you tell us more about plans for the future of CACE?
• 17:53
  SPEAKER_03: What comes next?
• 17:55
  SPEAKER_02: Sure, I can start.
• 17:56
  SPEAKER_02: So as Joanna mentioned, we have CarePath going on right now, which I think is so exciting.
• 18:02
  SPEAKER_02: We know that it is a priority from the core elements that we should be measuring adherence to guidelines, not just that you have guidelines present at your facility, but who is using them, how are they using them, how well are they adhering to them.
• 18:17
  SPEAKER_02: And we haven't really seen a great way to do that.
• 18:19
  SPEAKER_02: And so in this uh initiative, facilities will be able to receive a report that shows how they're doing with their adherence to these, the tools that Joanna mentioned, common infections, things like UTI, pneumonia, and skin and soft tissue infections.
• 18:36
  SPEAKER_02: So that is a nine-month initiative that we're working on now with quite a few hospitals throughout our state.
• 18:42
  SPEAKER_02: And as Joanna mentioned, we have the free tools available through First Line and through our website to help with that as well.
• 18:48
  SPEAKER_02: So that's a big focus right now that we're very excited about.
• 18:52
  SPEAKER_02: And then another thing that I think we think about a lot in public health and particularly when it comes to our own communities is health equity and access.
• 19:02
  SPEAKER_02: And so one of the things that we're doing is looking at our counties and our census tracts of the hospitals that we've served through CASE to evaluate our region to populations affected by health disparities.
• 19:14
  SPEAKER_02: And so we're able to take some of the indices like the SBI and others to evaluate the, again, the county or the census tract that the hospital is located in, just to see how much of our state are we reaching that in order to ensure that we are reaching people with health disparities.
• 19:32
  SPEAKER_02: So we're excited about that work as well.
• 19:34
  SPEAKER_02: And that's kind of a next step in now that we are in our fourth year, taking a look at the past three years and what our reach has been.
• 19:42
  SPEAKER_03: Thanks, Lauren.
• 19:43
  SPEAKER_03: Those sound like such important next steps.
• 19:45
  SPEAKER_03: Michael, anything to add about next steps from your perspective?
• 19:48
  SPEAKER_00: Yeah, I was just going to build off of what some of Lauren had said.
• 19:51
  SPEAKER_00: We're excited for the fact that we that we're able to keep this program going.
• 19:55
  SPEAKER_00: And I think in addition to what we're doing with CarePath and what Lauren had mentioned, is really just kind of taking that looking back and trying to better evaluate with the data that we have, what has our impact been?
• 20:05
  SPEAKER_00: So kind of helping to build almost a blueprint.
• 20:07
  SPEAKER_00: Um, so that if other facilities or other states want to build on these forms of collaborations, they kind of like that that um they can learn vicariously through what we've done, that what's worked for us or what hasn't worked for us, so they can kind of improve upon their own efforts.
• 20:20
  SPEAKER_00: Because it's really one thing I'd like to share is that when it comes to any other individual working in stewardship, whether it's at the hospital at a large academic center or smaller institution, is that if you want to start a collaborative like this, it's really just about reaching out and asking questions.
• 20:36
  SPEAKER_00: I'm a super introvert, I don't like talking to a lot of people, but working with the case team and everybody at CDPHE has been absolutely fantastic.
• 20:44
  SPEAKER_00: Everybody is willing, because we all have that at the end of the day, we all have that same goal is to improve antimicrobial use across the board.
• 20:50
  SPEAKER_00: And really, when you find other like-minded individuals, you're able to build these teams where even if I personally don't know anything about statistics, but we have wonderful members on our team from CDPHE that really know this stuff.
• 21:01
  SPEAKER_00: So you can build that team and you can pull these people together to really get any kind of products you want going off the ground.
• 21:07
  SPEAKER_00: All it just takes is sending that first, that first email.
• 21:10
  SPEAKER_03: Yeah, Michael, I think that's such great advice.
• 21:12
  SPEAKER_03: Just not to be afraid to reach out and to start building those bridges.
• 21:17
  SPEAKER_03: The question can't hurt.
• 21:19
  SPEAKER_03: And, you know, hopefully it starts a collaborative or a project or an investigation.
• 21:24
  SPEAKER_03: But even if it doesn't, like it builds that connection for the next time and the next question.
• 21:30
  SPEAKER_03: Um, Lauren, I'd also like to hear from your perspective.
• 21:33
  SPEAKER_03: Like any recommendations for listeners from the public health side about building these collaboratives.
• 21:41
  SPEAKER_02: Yeah, thank you, um, Maria.
• 21:43
  SPEAKER_02: I think Michael said it so well.
• 21:46
  SPEAKER_02: And um I think you know, the other thing is that in stewardship, there are so many common themes, whether we're working on penicillin allergies or durations of therapy, we have common themes in what we're doing.
• 21:57
  SPEAKER_02: And so by working together, we can see how other people are.
• 22:00
  SPEAKER_02: Are working to achieve that and learn from each other.
• 22:02
  SPEAKER_02: So I completely agree with his comments.
• 22:05
  SPEAKER_02: As far as from public health, I think one of the things that we have the benefit of is data.
• 22:10
  SPEAKER_02: And so one thing that we've strived to do within CACE is have a data-driven approach to what we do.
• 22:16
  SPEAKER_02: So Michael started with the initial survey that led to the formation of CACE.
• 22:21
  SPEAKER_02: And then every year we take feedback from our participants, and that's what guides our workshop topics and our speakers for the next year.
• 22:30
  SPEAKER_02: The other thing we have within public health is all of the data through NHSN that may be helpful.
• 22:36
  SPEAKER_02: So whether that's annual hospital survey data, core elements, or if there's a specific infection that you're targeting that maybe you have access to, any of that data can help to guide your series and make sure that just like Michael was saying, it's practical and applicable to the hospitals that you're working with.
• 22:56
  SPEAKER_02: And so I think my biggest recommendation would just be to take a data-driven approach when you're designing these kinds of collaboratives.
• 23:03
  SPEAKER_03: Great.
• 23:03
  SPEAKER_03: That's really helpful.
• 23:05
  SPEAKER_03: Anything that you wish you had known before you started?
• 23:10
  SPEAKER_00: That is a great question.
• 23:12
  SPEAKER_00: Hindsight is always 2020, as I say.
• 23:15
  SPEAKER_00: I think something that I wish I had known looking back was that just how eager people are to help.
• 23:24
  SPEAKER_00: Like Lauren said, in the last couple of years, as we started this initiative drawing largely from our own internal resources, but as we've expanded or as we've come across topics from our cohort that they wanted us to delve more into, we just realized that we may not be the best individuals to speak about that.
• 23:40
  SPEAKER_00: And so that kind of that's how we started branching out, talking to experts from other institutions or even from different states or organizations.
• 23:48
  SPEAKER_00: And then all these people, they're all, we all have the same goal at the end of the day.
• 23:51
  SPEAKER_00: So just not being afraid of reaching out and asking that question.
• 23:54
  SPEAKER_00: The worst thing people will say is no.
• 23:56
  SPEAKER_00: But because of this reach out or really listening to our crowd, that we've been able to pull in some outstanding speakers for a workshop series.
• 24:03
  SPEAKER_02: The other thing I was going to say is that I think one of the things that as healthcare professionals, there's a lot that we aren't taught, right?
• 24:12
  SPEAKER_02: And so one of the things I think is project management.
• 24:15
  SPEAKER_02: And when it comes to these larger series, there's a lot of project management involved.
• 24:20
  SPEAKER_02: And so I think if you're embarking on something like this and you think to yourself, how am I going to, you know, um coordinate a nine-month series with 30 hospitals?
• 24:30
  SPEAKER_02: But then if you, you know, try to teach yourself and do some work in project management, it can just be a really great skill that again, that wasn't taught in pharmacy school.
• 24:39
  SPEAKER_02: I don't think it's really taught in medical school, but it's skills that can be so helpful when you are working with partners and in a collaborative like this.
• 24:47
  SPEAKER_03: That was wonderful advice, Lauren and Michael.
• 24:51
  SPEAKER_03: Really want to thank you and Joanna for sharing your inspiring and impactful work.
• 24:56
  SPEAKER_03: And I also want to note if our listeners would like to start a similar effort in their state or be involved, that every state has a healthcare associated infections antimicrobial resistance program at their health department.
• 25:09
  SPEAKER_03: And we are providing a link to a map that has information about those programs and contacts with the podcast information and with those links to the case website as well.
• 25:20
  SPEAKER_03: Thank you very much to our listeners, and we hope you will tune in for the second podcast on healthcare collaboratives in the coming months.