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Statewide Antibiotic Stewardship: : An eBrightHealth Choosing Wisely Initiative.

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    A collaborative initiative across five health systems reduced overall antibiotic utilization by 9% through implementing antibiotic time-outs and improving prescribing for respiratory infections. Multidisciplinary teams enhanced antibiotic stewardship in both inpatient and ambulatory settings.

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    Area of Science:

    • Public Health
    • Infectious Disease
    • Healthcare Management

    Background:

    • Antibiotic stewardship is a national priority, with increasing requirements for programs in acute care hospitals and proposed initiatives for ambulatory settings.
    • Effective antibiotic stewardship is crucial for combating antimicrobial resistance and improving patient outcomes.

    Purpose of the Study:

    • To implement a collaborative statewide antibiotic stewardship initiative.
    • To enhance antibiotic prescribing practices in both ambulatory and inpatient healthcare settings.

    Main Methods:

    • Five Delaware health systems formed internal teams to implement process improvements.
    • Interventions included antibiotic time-outs, improved prescribing for upper respiratory infections, and a "all teach, all learn" methodology.
    • Utilized monthly conference calls and quarterly face-to-face meetings for a learning network.

    Main Results:

    • All inpatient teams implemented antibiotic time-outs in at least one unit.
    • Interventions included commitment posters, national data submission, surveys, stewardship champions, and prescribing feedback.
    • Overall antibiotic utilization decreased by 9% compared to the pre-intervention period.
    • Barriers included competing priorities, data limitations, and suboptimal provider engagement.

    Conclusions:

    • Multidisciplinary teams from diverse healthcare systems can successfully collaborate on antibiotic stewardship projects.
    • The initiative demonstrated the value of collaborative efforts in promoting appropriate antibiotic use.
    • All participating teams successfully implemented new initiatives to enhance antibiotic stewardship.