Steps 5 and 6: Empower and Plan

Step 5:  Empower Others to Act on the Vision

The ASP emphasizes the betterment of patient safety and quality of care.  There is a variety of means to deliver this, though not all of them work for all facilities.  Tailoring interventions to address local problems will improve buy-in from clinicians.  Interventions may be concurrent.  Examples:

  • Prospective audit and feedback
    • Frequent direct interactions with prescribers and team pharmacists to review patients on or in need of antibiotics (“stewardship rounds”) are opportunities to educate clinicians and trainees - future prescribers - on antimicrobial stewardship principles.
  • Guidelines and clinical pathways
    • Evidence-based, utilizing local susceptibility data
    • IV to PO conversion, dose optimization, de-escalation
    • Peri-operative prophylaxis
  • Align drug formulary with susceptibility data to encourage appropriate antibiotic use
  • Automatic review of positive blood cultures to ensure appropriate empiric treatment for serious diseases such as blood stream infections.
    • May be conducted by a non-physician member of the ASP team (e.g. Pharmacist) with support
  • Automatic review of specific antimicrobials

Step 6:  Plan for and Create Short-Term Wins

Start your change in areas where you anticipate you can achieve short-term wins.  This could be areas of high antimicrobial consumption, high resistance rate, or the most welcoming.  Engage local leaders early to facilitate goodwill and ensure success and generate momentum and word-of-mouth!  Successes should be highlighted and broadcasted.  Individuals involved should be recognized.

Examples:

  1. Hospital News
  2. SHS-UHN ASP Newsletter Sample

Reference(s):

  • Morris AM, et al. Healthc Q 2010;13(2):64-70.
  • CDC Get Smart for HealthCare Website

Next:  Steps 7 and 8:  Consolidate and Anchor