Pharmacy Services, Intermountain Healthcare, Taylorsville, Utah, USA.
Division of Clinical Epidemiology and Infectious Diseases, Intermountain Healthcare, Salt Lake City, Utah, USA.
Clin Infect Dis. 2022 Nov 30;75(11):2038-2044. doi: 10.1093/cid/ciac515.
Twenty of 21 health systems and network-based antimicrobial stewardship programs (ASPs) who were invited participated in a questionnaire, a webinar, and focus groups to understand implementation strategies for system-wide antimicrobial stewardship. Four centralized ASPs structures emerged. Of participating organizations, 3 (15%) confirmed classification as collaborative, 3 (15%) as centrally coordinated, 3 (15%) as in between or in transition between centrally coordinated and centrally led, 8 (40%) as centrally led, 2 (10%) as collaborative, consultative network. One (5%) organization considered themselves to be a hybrid. System-level stewardship responsibilities varied across sites and generally fell into 6 major categories: building and leading a stewardship community, strategic planning and goal setting, development of validated data streams, leveraging tools and technology for stewardship interventions, provision of subject-matter expertise, and communication/education. Centralized ASPs included in this study most commonly took a centrally led approach and engaged in activities tailored to system-wide goals.
21 个卫生系统和基于网络的抗菌药物管理计划（ASPs）中有 20 个应邀参与了问卷调查、网络研讨会和焦点小组，以了解全系统抗菌药物管理的实施策略。四种集中的 ASP 结构出现了。在参与的组织中，有 3 个（15%）确认分类为协作型，3 个（15%）为集中协调型，3 个（15%）为介于集中协调型和集中领导型之间或正在向集中领导型过渡，8 个（40%）为集中领导型，2 个（10%）为协作型、咨询网络。一个（5%）组织认为自己是混合组织。各参与机构的系统层面的管理职责因地点而异，通常分为六大类：建立和领导管理社区、战略规划和目标设定、开发经过验证的数据流、利用工具和技术进行管理干预、提供专题知识以及沟通/教育。本研究中包含的集中 ASP 最常见的方法是集中领导，并针对全系统目标开展活动。
