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Healthcare PlexusCall - Antimicrobial Stewardship: Resistance Is Futile
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When: Wednesday, December 12, 2012
1-2pm eastern

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Healthcare PlexusCall (formerly Health Quality Call)
Wednesday, December 19, 2012 - 1-2pm ET
Topic: Antimicrobial Stewardship: Resistance Is Futile
Guests: Maureen Angel and Sarah Beaty-Vandemark

MP3 File


Humans share the world with bacteria—sometimes harmoniously, sometimes not. Before the discovery of penicillin and other antibiotics in the 1920s to 1940s, bacterial diseases were often deadly. Antibiotics were welcomed and widely prescribed for human patients --and later, for animals raised for food.

Bacteria, however, are highly adaptive; they reproduce rapidly, and can pass genetic traits—including antibiotic resistance--not only to succeeding generations, but also to other bacteria in their environment. Almost from the beginning, doctors noted that penicillin was not always useful against some strains of Staphylococcus aureus, and the problem has grown worse, involving other bacteria and antibiotics. Today methicillin-resistant Staphylococcus aureus causes serious infections for many thousands, and killed 11,748 Americans in 2010. Antibiotic use makes patients more vulnerable to Clostridium difficile, a drug-resistant bacteria that causes severe diarrhea, and is responsible for around 14,000 American deaths a year. Other less common organisms have developed resistance to several or all known antibiotics, leaving physicians with limited options for patient care.

Hospitals bring together patients, bacteria, and antibiotics in a complex mix that defies easy solutions. In addition to finding ways to treat patients effectively, hospitals are now working on programs to use antibiotics more judiciously. I asked Molly Angel, project manager focusing on antimicrobial resistance at Providence Health and Services, whether hospital staff resisted changing their practices. "Only the bacteria are resistant,” she replied. "We all understand the need. But it’s such a big thing to get our arms around, complex and multifaceted. We have to think how to start, how to scale up or scale down, what methodology to use to structure the project, what will be most efficient and effective—nobody has extra time.” Molly and Sarah Beaty-Vandemark, hospital pharmacist, will join the call to talk about how the Antimicrobial Stewardship team is addressing these and other concerns. There will be a chance to ask questions, and they are looking forward to hearing what your hospital is doing about this important issue.

Maureen (Molly) Angel is Project Manager, Quality, for Providence Health and Services. Since coming to Providence in 2007, she has provided primary project management for forty clinical improvement projects through Accelerating Clinical Improvement (ACT). The ACT initiative provides funding and project support for projects submitted by clinicians from within the Providence system, These projects have included CAUTI reduction, Antimicrobial Stewardship, eICU outreach, sepsis mortality reduction, ICU delirium, and reduction in readmission for CHF patients across our system of 29 acute care hospitals working with multidisciplinary clinical teams.

Her background includes physician practice management, clinical research grant administration, clinical service line administration and lean trained quality improvement project management in academic medical centers, community hospitals and multifacility integrated delivery systems. She has provided administrative direction for ICU, Surgical Services, Respiratory Therapy, Sleep Center, Cardiovascular Cath Lab, Cardiac Rehab and Pharmacy departments and services, with responsibilities including program planning, budget, new business services and management training.

She holds a B.S.B.A. in Finance from Miami University and an M.B.A. in International Business from Xavier University. To support knowledge transfer for the ACT projects, her additional training includes use of Liberating Structures, Contextualist approach and knowledge transfer packet creation. She provides training for these techniques to the Operational Excellence and project management teams in Providence. Additionally, she has managed an AHRQ ACTION II grant for a novel approach to the reduction of MRSA using Positive Deviance in a Providence hospital in Missoula, MT.

You can contact Molly at

Sarah Beaty-Vandemark is the System Director of Pharmacy Program Development for Providence Health & Services. Her responsibilities focus on the design, implementation, and outcomes of pharmacy clinical operations/programs, such as antimicrobial stewardship. In this initiative, she has been directly involved in all phases of antimicrobial stewardship, from direct involvement in program design and implementation on an individual hospital level, to evaluating the clinical outcomes of these programs on the health-system level. She actively participated in the AMS summit, a system-wide multidisciplinary networking summit to determine process, structure, function, and outcomes for antimicrobial stewardship programs.

 She graduated for Washington State University with her bachelor’s in pharmacy, then achieved her PharmD in 2000. She received her MBA from City University in 1990, and became board certified in Pharmacotherapy in 1993. She is also affiliate faculty at both Washington State University and the University of Washington.

She has worked in a variety of pharmacy positions at Swedish Hospital, and also Highline Medical Center. She was instrumental in these positions at advancing pharmacy clinical practice and training, through internships, externships, and a residency program. Since coming to Providence in 2007, she has worked as the Regional Director, Pharmacy Clinical Services for the Washington/Montana regions, before moving into her current position.

You may contact Sarah at

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