Hawaii Antimicrobial Stewardship Collaborative (HASC)

The overuse and misuse of antibiotics are associated with increasing prevalence of infections with multi-drug resistant organisms and Clostridium difficile infections, leading to patient harm. Antimicrobial stewardship programs (ASPs) have been shown to improve individual patient outcomes, reduce the overall burden of antibiotic resistance, and save healthcare dollars. The Hawaii Department of Health (HDOH) has been working with Hawaii’s healthcare facilities to facilitate the development of antimicrobial stewardship capacity in our state. Many Hawaii facilities have components of an ASP and/or are in various stages of formally implementing an ASP; some facilities already have a full ASP in place.

HDOH, the Daniel K. Inouye College of Pharmacy at the University of Hawaii at Hilo, and several Hawaii healthcare facilities are working together to establish the Hawaii Antimicrobial Stewardship Collaborative (HASC). HASC is a voluntary collaborative designed to help facilities develop, implement, and sustain ASPs.

The primary goals of HASC are:

  1. Implement and sustain ASPs in participating facilities
  2. Reduce antimicrobial use in participating hospitals
  3. Reduce healthcare-onset Clostridium difficile infections

Read the HASC Charter

Core Elements of Outpatient Antibiotic Stewardship

As more than 60% of antibiotic expenditures for humans occur in the outpatient setting in the United States, it is vital that these settings are targeted for antibiotic stewardship efforts. The Core Elements of Outpatient Antibiotic Stewardship provides a framework for antibiotic stewardship for outpatient clinicians and facilities that routinely provide antibiotic treatment. The four components of the core elements are:

Demonstrate dedication to and accountability for optimizing antibiotic prescribing and patient safety.

Action for Policy and Practice
Implement at least one policy or practice to improve antibiotic prescribing, assess whether it is working, and modify as needed.

Tracking and Reporting
Monitor antibiotic prescribing practices and offer regular feedback to clinicians, or have clinicians assess their own antibiotic prescribing practices themselves.

Education and Expertise
Provide educational resources to clinicians and patients on antibiotic prescribing, and ensure access to needed expertise on optimizing antibiotic prescribing.

Healthcare professional can prevent the spread of antibiotic resistance by:

  • Prescribing an antibiotic only when it is likely to benefit the patient.
  • Prescribing an antibiotic that targets the bacteria that is most likely causing their patient’s illness when an antibiotic is likely to provide benefit.
  • Encouraging patients to use the antibiotic as instructed.
  • Collaborating with each other, office staff, and patients to promote appropriate antibiotic use
  • Continue reviewing and following the latest clinical practice guidelines for common infections, such as CDC’s Adult and Pediatric Academic Detailing Sheets.


Participating HASC Facilities in Hawaii

The following facilities have committed to improving the judicious use of antimicrobials in their facility and participate in HASC:

FacilityASP LeadContact
Castle Medical CenterAnne Massie, Infection Prevention Coordinator
Hawaii State HospitalDalia Bowling, Clinical Pharmacist Specialist Dalia.bowling@doh.hawaii.gov
Hilo Medical CenterNelson Nako, Pharmacy Director nnako@hhsc.org
Kahuku Medical CenterChris Tsue, Director of Pharmacyctsue@kmc-hi.org
Kapiolani Medical Center for Women and ChildrenLen Yonemura, Medication Safety Coordinator len.yonemura@kapiolani.org
Kauai Veterans Memorial HospitalKristie Canavan, Kauai Region Director of Pharmacy kcanavan@hhsc.org
Kona Community HospitalMarilinda Passon, Pharmacy Director mpasson@hhsc.org
Kuakini Medical CenterWendy Zarella, Pharmacy Supervisor w.zarella@kuakini.org
Maui Memorial Medical CenterJeff Tsai, Clinical Pharmacist/Clinical Coordinator jtsai@hhsc.org
Molokai General HospitalNicolelee Kalipi, Medical Records Supervisornkalipi@queens.org
North Hawaii Community HospitalAnthony Fazio, Director of Pharmacy Services afazio@queens.org
Pali Momi Medical CenterCarlotta Meier-Irving, Director of Pharmacy carlotta.meier-irving@palimomi.org
Rehabilitation Hospital of the PacificAudrey Arita, Infection Preventionist/Clinical Nurse Specialist aarita@rehabhospital.org
Shriners Hospitals for Children – HonoluluDayne Fujimoto, Pharmacy Manager dfujimoto@shrinenet.org
Straub Clinic & HospitalJoy Matsuyama, Pharmacy Director joy.matsuyama@hawaiipacifichealth.org
The Queen’s Medical CenterLynn Matsukawa, ASP pharmacistlmatsukawa@queens.org
Tripler Army Medical CenterSusan Eade-Parson, Clinical Pharmacist susan.h.eadeparson.civ@mail.mil
Wahiawa General HospitalShelly McComas, Director of Pharmacy slmccomas@wahiawageneral.org
Wilcox Memorial HospitalKaren Sison, Pharmacistkaren.sison@wilcoxhealth.org

Useful Links

CDC Resources for Outpatient Healthcare Professionals

CDC Get Smart About Antibiotics Toolkit

For more information on Antimicrobial Stewardship, visit the CDC’s website.