The impact of a best practice advisory for shifting to oral medications: A quality improvement project

We developed a Best Practice Advisory (BPA) to encourage switching from intravenous (IV) to oral (PO) formulations of antimicrobials with equal efficacy, to decrease costs and IV usage. We conducted a prospective study analyzing our BPA's effect on prescribing practices of antimicrobials in the inpatient setting of Stanford Hospital in Palo Alto, CA, over a 22-month period. Our BPA achieved a 1526/6585 (23.2%) acceptance rate and led to decreased use of IV antimicrobials, with substantial direct cost savings of at least $66,976. Future efforts will focus on expanding our BPA to non-antimicrobials given ongoing IV fluid shortages.