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Engaging hospitalists in antimicrobial stewardship: Lessons from a multihospital collaborative.

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Implementing antimicrobial stewardship best practices in hospitals significantly improves documentation and reduces unnecessary antimicrobial use. Key facilitators include physician engagement and real-time data feedback, overcoming practice variability barriers.

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Area of Science:

  • Infectious Diseases
  • Hospital Medicine
  • Public Health

Background:

  • Inappropriate antimicrobial use in hospitals fuels antimicrobial resistance and patient complications.
  • Effective antimicrobial stewardship programs are crucial for combating these issues.

Purpose of the Study:

  • To assess the impact of antimicrobial stewardship best practices.
  • To identify barriers and facilitators to implementing these practices in diverse hospital settings.

Main Methods:

  • A multihospital initiative involving community and academic medical centers.
  • Multimodal physician education on enhanced documentation, clinical guidelines, and antimicrobial timeouts.
  • Analysis of implementation barriers and facilitators.

Main Results:

  • Significant improvement in antimicrobial documentation in two hospitals (4% to 51% and 8% to 65%).
  • 726 antimicrobial timeouts conducted, with 30% leading to optimization or discontinuation.
  • Physician practice variability and lack of awareness were key barriers.

Conclusions:

  • Hospitalists can successfully implement antimicrobial stewardship.
  • Engaging clinicians, providing data feedback, and tailoring interventions are critical facilitators.