Dear Hospital Colleague,
Engaging pharmacists in antibiotic stewardship has the potential to advance stewardship in
hospital settings. Knowing this, the Georgia Department of Public Health (DPH) is supporting
infectious disease training for pharmacists to assist them in engaging in antimicrobial
stewardship activities in their hospitals. Depending on the already on-going stewardship
activities in a hospital and the current training of the hospital pharmacist, we have two programs
for which hospitals can apply to have their pharmacist participate. The training will be conducted
by Making a Difference in Infectious Diseases Pharmacotherapy (MAD-ID; http://mad-id.org/),
a non-profit organization that provides continuing professional education in the area of infectious
diseases pharmacotherapy.
1.
Basic Program. Designed to teach the basic skills and provide an overview of
Antimicrobial Stewardship practices needed to develop an Antimicrobial Stewardship
Program. The basic program includes the MAD-ID internet learning module on basic
concepts (9 hours), live programming consisting of further online lessons with associated
teleconferences with faculty (7 hours) that address more advanced concepts and principles,
application and implementation issues, and a final practical component/exercise (3 hours).
What DPH Will Cover: DPH will pay registration for the on-line training program and
provide $2,000 to the hospital as compensated training time for the pharmacists so that they
can complete the coursework. This will enable the hospital to cover the hours of the
participating pharmacist, while participating in training.
Hospital Responsibilities: The hospital will identify a pharmacist to complete the MAD-ID
internet learning modules on basic concepts (9 hours) and live programming (7 hours),
submit documentation of its completion along with an outline of the pharmacist’s final
project to DPH by July 31, 2014. The hospital will also submit an application for the
Georgia Honor Roll for Antibiotic Stewardship by July 31, 2014 (for details, see
http://dph.georgia.gov/georgia-honor-roll-antibiotic-stewardship).
2.
Advanced Program: Designed to meet the ongoing educational needs for those
practitioners who have stewardship practice experience and/or basic education and skills
training in this area of practice. The advanced program is conducted at the 2014 Annual
MAD-ID conference in Orlando, Florida on May 29-31, 2014. The pharmacist will complete
12.5 hours of coursework at the conference. A final practical component/exercise is also
required after the conference.
What DPH Will Cover: DPH will pay registration for the in-person training and reimburse
travel expenses for the pharmacist designated by the hospital to attend the MAD-ID
conference. Travel expenses will include transportation, hotel (up to 3 nights at conference
hotel), and per diem in accordance with state travel guidelines.
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Hospital Responsibilities: The hospital will identify a pharmacist to attend the conference
training, submit documentation of completion of 12.5 hours coursework at the meeting, and
submit an outline of a final project to DPH by July 31, 2014. The hospital will also submit
an application for the Georgia Honor Roll for Antibiotic Stewardship by July 31, 2014 (for
details, see http://dph.georgia.gov/georgia-honor-roll-antibiotic-stewardship).
Continuing Education. MAD-ID offers continuing education units for both programs. Please
consult the MAD-ID web site (http://mad-id.org/) for more information.
An application to participate is attached. If you are chosen to participate, the Department of
Public Health will enter into a Memorandum of Agreement (MOA) with you that will detail the
mutual responsibilities and enable payment for compensated training time, as well as the
registration and reimbursement of pharmacist travel expenses. (See attached sample MOA.)
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HOSPITAL ANTIBIOTIC STEWARDSHIP TRAINING APPLICATION
How to Apply:
Hospital Name and City: _______________________________________
Pharmacist Name:______________________________________________
Pharmacist Work Phone and Email: ________________________________
Hospital Contact*: _______________________________________________
(*with authority to approve pharmacist’s participation and hospital’s engagement in
MOA)
Hospital Contact Work Phone and Email:
_____________________________ (phone)
______________________________ (email)
____________________________________________________________________
HOSPITAL SHOULD COMPLETE HOSPITAL INFORMATION ON THE
ATTACHED FORM
THE PHARMACIST SHOULD COMPLETE THE SECTION BELOW TO BE
SUBMITTED WITH THE APPLICATION
Please describe how this training will benefit your hospital and greater community (300
words or less):
Submit application to Jeanne Negley (jenegley@dhr.state.ga.us or 404-657-2593) by April 4,
2014. Contact Ms. Negley with any questions related to this program.
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The applications will be reviewed by the Georgia Antibiotic Stewardship Subcommittee and
recipients will be announced by April 14.
Additional Requirements:
1. Each hospital will be required to enter into a memorandum of understanding with DPH.
2. Each hospital needs to have on file or submit a W-2 to DPH.
Additional Information:
Basic Program:
1. For support of the compensated training time, hospitals need to submit documentation of
completion of the two modules (representing 16 hours of programming), submit an
outline of the practical project, and an invoice to DPH for the $2,000 towards
compensated training time.
Advanced Program:
1. For the Advanced Program, pharmacists need to directly submit to DPH an invoice for
travel expenses according to the following schedule:
a. Hotel costs will not exceed $475. This includes three days at the conference hotel
at a rate of $157.50 per day for three days (including taxes/fees).
b. Per Diem will not exceed $154.75. This is based on the federal per diem rate of
$52 per day for Orlando, Florida, excluding breakfast meals included in
conference registration and at a rate of 75% on travel days (www.gsa.gov).
c. Transportation. Participants have the option to select travel by plane/airport
shuttle service or by personal vehicle.
i. Costs for plane/shuttle service will not exceed $400.
ii. Costs for driving to the conference will not exceed $250 at a rate of $0.56
per mile).
iii. Parking (airport or hotel) will not exceed $30.
iv. Receipts must be submitted for all transportation costs, except meals
which will be reimbursed based on the per diem chart below.
Meal
Breakfast
Lunch
Dinner
Incidentals
75% on travel days
Total
Calculation of Per Diem Reimbursement
May 28
May 29
May 30
29
5
(applies)
25.5
13
29
5
13
29
5
47
47
4
May 31
13
29
5
(applies)
35.25
HOSPITAL INFORMATION:
Legal Name of Hospital for MOA:
FEI #:
DUNS NUMBER:_
FY End Date
Programmatic Contact:
Name
Address (Street, City, State, Zip)
Phone Number
Email
Business Contact:
Name
Address (Street, City, State, Zip)
Phone Number
Email
Type of Business: (check one)
Non-Profit_(_)_Public Corporation_(_)_Governmental_(_)_Other_(_)_
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