Use of computer decision support in an antimicrobial stewardship program (ASP)

Area of Science:

• Healthcare Informatics
• Clinical Pharmacy
• Infectious Diseases

Background:

• Antimicrobial stewardship programs (ASPs) face challenges with electronic systems, leading to manual data searches and workflow interruptions.
• Inefficient information access hinders the ability of ASPs to prospectively audit antimicrobial use and provide timely feedback to clinicians.

Purpose of the Study:

• To identify information needs and workflow gaps within current electronic applications and reports for ASPs.
• To develop and implement new applications to improve the prospective auditing capabilities of ASPs and enhance antimicrobial use.

Main Methods:

• A framework was developed to integrate patient data from electronic medical records, data warehouses, and alert files.
• New applications were created using input from pharmacists and infectious disease physicians, aligning with CDC/NHSN antibiotic utilization specifications.
• Alerts and reports were generated and disseminated via pagers, emails, and the National Healthcare Surveillance Network (NHSN).

Main Results:

• Four novel applications were successfully developed and implemented at Intermountain Medical Center (IMC) and Primary Children's Hospital (PCH).
• These applications facilitated the use of updated CDC/NHSN antibiotic utilization specifications.
• Data from IMC and PCH demonstrated a general decrease in the targeted antimicrobial drug utilization.

Conclusions:

• Effective ASPs require substantial amounts of timely and accessible patient information.
• The newly developed applications significantly improved the efficiency of antimicrobial use review and patient prioritization.
• These advancements enable ASPs to optimize patient care through more effective antimicrobial stewardship.