Johnson Morgan C, Bennett Jessica, Kaucher Angela, Davis Kelly, Staub Milner, Thomas-Gosain Neena
Veterans Affairs Tennessee Valley Healthcare System, Nashville.
Lt. Col. Luke Weathers, Jr. Veterans Affairs Medical Center, Memphis, Tennessee.
Fed Pract. 2023 Dec;40(12):412-417. doi: 10.12788/fp.0441. Epub 2023 Dec 12.
Antimicrobial stewardship programs (ASPs) are vital to improving patient safety and ensuring quality of care but are often underresourced, limiting their effectiveness and reach. While barriers to ASP success have been well documented, approaches to address these barriers with limited resources are needed. Stewardship networks and collaboratives have emerged as possible solutions. In January 2020, 5 US Department of Veterans Affairs facilities created a regional ASP collaborative. In this article, we describe the impact of this collaborative on the productivity of the facilities' ASPs.
ASP annual reports for each of the 5 facilities provided retrospective data. Reports from fiscal year (FY) 2019 and reports from FY 2020-2022 were reviewed. Staffing, inpatient and outpatient stewardship reporting, individual and collaborative initiatives, and publications data were collected to measure productivity. Yearly results were trended for each facility and for the region. Additionally, the COVID-19 antibiotic use dashboard and upper respiratory infection dashboard were used to review the impact of initiatives on antibiotic prescribing during the collaborative.
Regular reporting of outpatient metrics increased; 27% of measures showed improvement in 2019 and increased to 60% in 2022. For all 5 facilities, ASP initiatives increased from 33 in 2019 to 41 in 2022 (24% increase) with a corresponding increase in collaborative initiatives from 0 to 6. Likewise, publications increased from 2 in 2019 to 17 in 2022 (750% increase). Rates of reporting and improvement in inpatient metrics did not change significantly.
The ASP collaborative aided in efficiency and productivity within the region by sharing improvement practices, distributing workload for initiatives, and increasing publications.
抗菌药物管理计划(ASP)对于提高患者安全性和确保医疗质量至关重要,但往往资源不足,限制了其有效性和覆盖范围。虽然ASP成功的障碍已有充分记录,但需要采用资源有限的情况下解决这些障碍的方法。管理网络和协作已成为可能的解决方案。2020年1月,美国退伍军人事务部的5个设施创建了一个区域ASP协作组织。在本文中,我们描述了这种协作对这些设施的ASP生产力的影响。
5个设施中每个设施的ASP年度报告提供了回顾性数据。审查了2019财年的报告以及2020 - 2022财年的报告。收集人员配备、住院和门诊管理报告、个人和协作举措以及出版物数据以衡量生产力。对每个设施和该地区的年度结果进行了趋势分析。此外,使用了COVID - 19抗生素使用仪表板和上呼吸道感染仪表板来审查协作期间举措对抗生素处方的影响。
门诊指标的定期报告有所增加;2019年27%的指标显示有所改善,到2022年增至60%。对于所有5个设施,ASP举措从2019年的33项增加到2022年的41项(增加了24%),协作举措相应地从0项增加到6项。同样,出版物从2019年的2篇增加到2022年的17篇(增加了750%)。住院指标的报告率和改善情况没有显著变化。
ASP协作通过分享改进实践、分配举措工作量和增加出版物,有助于提高该地区的效率和生产力。