Joint Commission Publishes Study on Successful Antimicrobial Stewardship Programs

Implementing them remains challenging for many hospitals, according to the commission.

Misuse of antibiotics may lead to antibiotic resistance, which accounts for more than 2 million infections and 23,000 deaths annually in the United States, according to The Joint Commission. It responded with a Medication Management standard for hospitals, critical access hospitals, and nursing care centers --a standard that became effective on Jan. 1, 2017 -- that requires them to have Antimicrobial Stewardship Programs (ASPs) in place in order to educate staff and patients, and their families, about the problem and how to prevent antibiotic resistance and prevent the spread of resistant infections.

A new study published in the February 2018 issue of The Joint Commission Journal on Quality and Patient Safety identifies common characteristics and innovative strategies among ASPs that are leading the way, according to the commission and the authors. The article, "The Expanding Role of Antimicrobial Stewardship Programs in Hospitals in the United States: Lessons Learned from a Multisite Qualitative Study," by Dr. Shashi N. Kapadia, M.D., instructor in medicine and in health care policy and research, Weill Cornell Medicine, New York City, and co-authors, reports on their findings from interviews they conducted with 12 program leaders at four prominent ASPs in the United States. The commission said their interview questions focused on ASP implementation, program structure, strengths and weaknesses, lessons learned, and future directions, and the authors identified three major themes that emerged from the data for successful approaches to ASPs:

  • Evolution from a top-down structure to a more diffuse approach involving unit-based pharmacists, multidisciplinary staff, and shared responsibility for antimicrobial prescribing under the ASPs' leadership
  • Integration of information technology systems to enable real-time interventions to optimize antimicrobial therapy and patient management
  • Barriers to technology integration, including limited resources for data analysis and poor interoperability between software systems

An accompanying editorial titled "Antibiotic Stewardship Grows Up" by Dr. Arjun Srinivasan, M.D., associate director for Healthcare Associated Infection Prevention Programs, Division of Healthcare Quality Promotion, CDC, says the article provides useful insights on how hospitals can implement their ASPs most efficiently and effectively.

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