TY - JOUR
T1 - Phased implementation of an antimicrobial stewardship program for a large community hospital system
AU - Burgess, L. Hayley
AU - Miller, Karla
AU - Cooper, Mandelin
AU - Moody, Julia
AU - Englebright, Jane
AU - Septimus, Edward
N1 - Publisher Copyright:
© 2019 Association for Professionals in Infection Control and Epidemiology, Inc.
PY - 2019/1
Y1 - 2019/1
N2 - Background: Antimicrobial stewardship is recommended as a crucial mechanism to reduce the emergence of antimicrobial resistance. The purpose of this article was to describe implementation of antimicrobial management programs (AMPs) across a large health system of community hospitals. Methods: The initiative was structured in 4 phases. Although each phase was implemented sequentially, facilities could progress at their own pace. Phase goals needed to be met before moving to the next phase. The 4 phases included preparatory, foundational, clinical care optimization, and refinement. A survey was administered prior to the initiative in 2010, and modified surveys were administered in 2015 and 2017. Results: Stewardship activities improved in most areas of the AMP initiative in 2015, with substantial improvement by 2017. Important changes included an increase in established programs, from 82% in 2010 to 88% and 96% in 2015 and 2017, respectively. Physician Champions increased from 73% in 2010 to 94% in 2017. Advances were made in the use of evidence-based treatment recommendations, antibiogram development, prospective audit and feedback for antimicrobials, tracking of antibiotic usage metrics, and a cost reduction of 40% from baseline. Conclusion: A well-designed, phased approach to implementing AMP can help community hospitals and hospital systems recognize substantial clinical and financial benefits.
AB - Background: Antimicrobial stewardship is recommended as a crucial mechanism to reduce the emergence of antimicrobial resistance. The purpose of this article was to describe implementation of antimicrobial management programs (AMPs) across a large health system of community hospitals. Methods: The initiative was structured in 4 phases. Although each phase was implemented sequentially, facilities could progress at their own pace. Phase goals needed to be met before moving to the next phase. The 4 phases included preparatory, foundational, clinical care optimization, and refinement. A survey was administered prior to the initiative in 2010, and modified surveys were administered in 2015 and 2017. Results: Stewardship activities improved in most areas of the AMP initiative in 2015, with substantial improvement by 2017. Important changes included an increase in established programs, from 82% in 2010 to 88% and 96% in 2015 and 2017, respectively. Physician Champions increased from 73% in 2010 to 94% in 2017. Advances were made in the use of evidence-based treatment recommendations, antibiogram development, prospective audit and feedback for antimicrobials, tracking of antibiotic usage metrics, and a cost reduction of 40% from baseline. Conclusion: A well-designed, phased approach to implementing AMP can help community hospitals and hospital systems recognize substantial clinical and financial benefits.
KW - Antibiotic
KW - Antimicrobial
KW - Antimicrobial management
KW - Antimicrobial stewardship
KW - Community hospital
KW - Healthcare system
KW - Physician champion
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U2 - 10.1016/j.ajic.2018.06.009
DO - 10.1016/j.ajic.2018.06.009
M3 - Article
C2 - 30082089
AN - SCOPUS:85050884742
SN - 0196-6553
VL - 47
SP - 69
EP - 73
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 1
ER -