From policing to partnerships: Implementation of a handshake antimicrobial stewardship program

Handshake antimicrobial stewardship (HAS) facilitates professional relationship building while ensuring safe and appropriate antimicrobial use. Development of a pharmacist-physician co-led HAS program requires interdisciplinary collaboration and coordination. In this case study, we describe our experience establishing a HAS program across 2 service lines.

A quality improvement framework was used to identify partnering services and program outcome metrics for HAS. Service lines with high antimicrobial utilization and/or limited antimicrobial stewardship contact were identified. Stewardship champions within partner service lines were identified to assist with HAS scheduling, coordination, and socialization. HAS programs were established with the hospital medicine and acute care surgery service lines and executed as scheduled once-weekly face-to-face rounds and review of all patients on systemic antimicrobials. One year post implementation, acceptance of HAS recommendations was greater than 80% for both services. Broad-spectrum antibiotic use decreased, and communication with stewardship pharmacists increased among intervention service lines. Program outcomes were communicated to quality and hospital leadership. Providers expressed high satisfaction with the HAS programs.

Creation of an HAS program requires data-informed, interdisciplinary collaboration between pharmacy, antimicrobial stewardship, administration, and partner prescribers and service lines. HAS facilitates stewardship efforts and simultaneously promotes stronger professional relationships with prescribers. Through regular face-to-face interactions with pharmacists via HAS, prescribers incorporate antimicrobial stewardship into daily practice and appreciate antimicrobial stewards as partners in advancing patient care.