L Hayley Burgess1, Karla Miller1, Mandelin Cooper2, Julia Moody1, Jane Englebright1, Edward Septimus3. 1. Hospital Corporation of America, Clinical Services Group, Nashville, TN. 2. Hospital Corporation of America, Clinical Services Group, Nashville, TN. Electronic address: mandelin.cooper@hcahealthcare.com. 3. Hospital Corporation of America, Clinical Services Group, Nashville, TN; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
Abstract
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.
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.
Authors: Tina M Khadem; Howard J Ergen; Heather J Salata; Christina Andrzejewski; Erin K McCreary; Rima C Abdel Massih; J Ryan Bariola Journal: Open Forum Infect Dis Date: 2022-05-09 Impact factor: 4.423