Antimicrobial Stewardship Program

Antimicrobial Stewardship Program (ASP) is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms. Implementation of an ASP is vital due to estimates that up to 50% of all antibiotics prescribed in hospitals are unnecessary or inappropriate. The historical RWJBarnabas Health ASP had foundational program elements of: surveillance of culture and sensitivity, de-escalation and escalation, IV to oral transitioning and renal adjustment of antimicrobial therapy. The Pharmacy Infectious Disease Collaborative worked with several disciplines to implement the following initiatives to strengthen the program.

Antimicrobial Stewardship Report Compliance with CMS.

To guide clinicians to the most cost effective therapy, filters that have been included in the lab system—suppress susceptibility panel to only include those agents that are most cost effective.

The documentation of indication for antimicrobial use is live in all facilities.

The metrics for success are the delays of antibiotic therapy and cost per day of antibiotic therapy.

The Pharmacy Enterprise migrated to measuring quality initiatives in a control chart methodology. The graphs displayed above are control charts, used to study how a process changes over time. Data are plotted chronologically. A control chart always has a central line for the average (highlighted in red), and upper line for the upper control limit (highlighted in green) and a lower line for the lower control limit (highlighted in purples). These lines are determined from historical data.