Amanda R. Nedved, MD
Medical Director, Blue Valley Urgent Care; Co-Director, Physician-Provider Organizational Support Quality Safety & Operation Excellence Program; Associate Professor of Pediatrics, University of Missouri-Kansas City School of Medicine; Clinical Assistant Professor of Pediatrics, University of Kansas School of Medicine
Full BiographyRana El Feghaly, MD, MSCI
Director, Infectious Diseases Clinical Services; Director, Outpatient Antibiotic Stewardship Program; Medical Director, Vaccines for Children (VFC) Program; Professor of Pediatrics, University of Missouri-Kansas City School of Medicine; Clinical Assistant Professor of Pediatrics, University of Kansas School of Medicine
Full Biography
Amanda Nedved, MD, Urgent Care, along with co-Primary Investigator Rana El Feghaly, MD, MSCI, Infectious Diseases, were awarded a two-year, $200,510 Investigator Studies Program (MISP) grant from Merck.
Drs. Nedved, and El Feghaly are using the funding on the project “Improving Health Equity in Antibiotic Prescribing for Respiratory Infections in Pediatric Urgent Care Clinics: A Multi-Center Quality Improvement Collaborative.”
Despite numerous studies confirming that health inequities in antibiotic prescribing behaviors exist, the drivers contributing to these inequities are not well studied.
The team’s collaborative are using QI methodology to identify primary drivers of health equity in antimicrobial stewardship (AMS) and develop, implement, and study the effect of interventions to narrow the existing gap in health inequities. For the current proposed project, the team has a new cohort of participating sites recruited from national society listservs such as Society of Pediatric Urgent Care (SPUC). SPUC previously collaborated with the CDC and the Antibiotic Resistance Action Center to develop a multi-site quality improvement (QI) collaborative, which successfully reduced unnecessary antibiotics and demonstrated how to use publicly available resources. The previous collaborative, however, did not evaluate the effect AMS interventions had on health equity.
The goals are to characterize health inequities in antibiotic prescribing for respiratory illnesses in pediatric urgent cares through this multi-center collaborative. The investigators will also use their findings to identify the root cause of health inequities in antibiotic prescribing. Finally, they hope to develop countermeasures to improve health equity in antibiotic prescribing for common pediatric infections in pediatric urgent care clinics nationally.
“Differences in antibiotic prescribing for different groups of people has been described in multiple studies,” said Dr. Nedved. “The reasons behind these differences are likely multifactorial. While implicit bias often plays a role in health inequities, we plan to thoroughly explore the contributing factors to these differences before considering effective ways to improve health equity in antimicrobial stewardship.”