991. Engaging Targeted End-Users using Clinical Surveillance Software (TheraDoc) for Antimicrobial Stewardship (ASP)
Session: Poster Abstract Session: Stewardship: Implementing Programs
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
  • IDSA 2013 Poster Presentation 991.pdf (643.9 kB)
  • Background:

    There are many quality improvement tools in the QA toolbox to improve the quality of care provided to patients.  We recognized that ASP was a clinical microsystem as it is a place where “care is made; quality, safety, reliability, efficiency, and innovation are made; and staff morale and patient satisfaction are made.”  Our institution chose a Clinical Microsystems approach to create our ASP.  In developing this program, we identified a patient care fractal: pharmacist – patient – medical professionals.  Historically, ASP has been a centralized process at our institution with a physician and pharmacist reviewing and responding to ASP issues.  We concluded that the best leverage for achieving our goals of insuring the right drug for the right bug, at the right dose, for the right duration and correct indication was to engage our end-users by employing a Clinical Surveillance Software Tool (TheraDoc).   We targeted this effort on the OSF SFMC unit pharmacists’ end user group.


    We developed a series of ASP clinical alerts in concert with our stated purpose, i.e. double anaerobic coverage, intravenous to oral conversion, culture negative bacteruria, and targeted drugs (Levofloxacin).  We obtained access to and trained our individual unit pharmacists on the use of TheraDoc, including the origin of the defined alerts and ASP consistent corrections. 


    Average monthly Pharmacy interventions: PRE ASP : 760, and POST ASP 845.  Additional intervention with use of TheraDoc: 210/month with 84% response rate.  Cost avoidance per month since ASP started: $150,650.  Cost avoidance since starting ASP to date: $2,259,724. We demonstrated reduction in targeted antimicrobials, i.e. Levofloxacin. We improved pharmacy/health professional survey satisfaction scores.


    Our institution’s experience with engaging one of our ASP end-users, Unit Pharmacists, has been successful to date. We have demonstrated improved quality of care with prompt and appropriate responses to our designed ASP alerts.  We have achieved this by not disrupting the flow of work of our pharmacist.  This new process design has eliminated waste (de-escalation alerts), improved workflow (engaging end-users; removing previously employed prior steps), and changed the unit work environments, encouraging the partnerships in the ASP Clinical Fractals.

    John Cotter, MD MPH, Medicine, University of Illinois College of Medicine - Peoria/OSF SFMC, Peoria, IL, Shweta Ramsahai, MD, Medicine, Univeristy of Illinois College of Medicine - Peoria/OSF SFMC, Peoria, IL and Julie Giddens, PharmD BCPS, Pharmacy, OSF SFMC, Peoria, IL


    J. Cotter, None

    S. Ramsahai, None

    J. Giddens, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.