Center for Antibiotic Utilization, Stewardship and Evaluation (CAUSE)
| Established in 2000, Wake’s Center For Antibiotic Utilization, Stewardship and Evaluation (CAUSE) has become a national model. While other hospitals’ antimicrobial drug costs increase fifteen to seventeen percent annually, CAUSE has helped Baptist Medical Center’s drug costs to remain flat. |
Since 2,000, CAUSE has helped WFUBMC avoid more than $1 million in infection-related costs.
Hospital-acquired infections are an all too common occurrence, each year affecting about two million patients and causing an estimated ten thousand deaths. Such infections take a financial toll on hospitals as well, adding significant costs to care. Seizing an opportunity to improve the health of patients and hospitals, Wake established the Center for Antibiotic Utilization, Stewardship and Evaluation (CAUSE) in 2000, one of the first infection-focused centers of its kind in the United States
Christopher Ohl, M.D., was recruited as the Center’s medical director. An associate professor in the Infectious Diseases section, Dr. Ohl’s passion is the diagnosis and therapy of bacterial, fungal, mycrobacterial, and viral infections.
The goals of CAUSE are all-encompassing—to reduce the amount and significance of antimicrobial resistance in hospital and community pathogens, improve patient outcomes, promote and implement outcomes analysis in antimicrobial utilization and resistance, and reduce the hospital’s antimicrobial costs. The center draws upon the intellectual resources of Infectious Diseases, Microbiology, Pharmacy, and Epidemiology to battle infection-causing “bugs.”
“Bugs are smart,” explains Dr. Ohl. “They are constantly adapting to antibiotics. If we use the same drugs, bacteria eventually figure it out and become resistant, making drugs ineffectual. One way to stay ahead is through data.”
CAUSE has developed ways to collect and monitor antimicrobe activity data by service line, section of the hospital and individual provider. They also monitor resistance in patients and in different areas of the hospital. These efforts have helped reduce microbial utilization for several complicated, expensive drugs and have provided important guidelines for physicians. Termed antimicrobial stewardship, it’s a concentrated effort to educate healthcare providers on the proper use of antimicrobials.
CAUSE directs and assists Wake providers through formal and informal education efforts as well as restriction programs. Dr. Ohl says common sense plays an important role, too. “It gets down to appropriately and adequately diagnosing the infection and then giving the right drug, in the right dose, for the right duration. Doing that has yielded better outcomes for our patients and a healthier bottom line for our hospital.”