Reporting on the usage and growing resistance to antimicrobials is a key objective for the California Department of Public Health (CDPH). In 2017, they engaged Lantana to encourage and support hospital reporting of Antimicrobial Use and Resistance (AUR) data to the Centers for Disease Control and Prevention (CDC) National Healthcare and Safety Network (NHSN). Lantana worked with over 70 hospitals to demonstrate the value of program participation and to support implementation through tools and education.

A survey created by Lantana and conducted by CDPH created a baseline measure of hospitals’ readiness to implement reporting based on infrastructure and resources. We divided the hospitals into three tiers (high, medium, low) based on maturity. Lantana customized an implementation plan for each hospital that requested support. For hospitals without AUR reporting software, we developed a tool to convert internal AUR data into a standards-compliant report. The tool converts the hospitals’ data into the Clinical Document Architecture (CDA) format NHSN requires. We helped hospitals validate their data against the submission requirements, created self-paced validation guides, and offered hands-on assistance to validate calculations.

Lantana developed statewide communication materials that explain the importance of AUR reporting to combating antimicrobial-resistant bacteria and describe the support available. We developed educational materials that introduce AUR and its components including PowerPoint slides, webinars, and short videos—all available on the CDPH website. We also developed case studies from successful reporting programs and invited hospitals to share lessons learned. Lantana supported the State as it set up a NHSN AUR Reporting Learning Collaborative. Within the Collaborative, experienced hospitals shared challenges and lessons learned with Collaborative members who were new to or interested in AUR reporting, creating a learning opportunity available to all California hospitals.

Key Outcomes:

• Increased the number of hospitals in California reporting AUR by approximately 15%
• Conducted six educational sessions with over 100 participants
• Engaged over 70 hospitals
• Supported validation of data and submission format
• Provided utilities to support submission
• Supported launch of a Learning Collaborative
• Responded to queries
• Provided feedback to NHSN AUR to improve the program

Tools and Methods Used:

• Data analysis and methodology
• Data validation
• Lantana validator
• Direct instruction
• Web-based learning
• XML to CDA Converter tool
• AUR CDA Converter tool