Educational Based Anti-Microbial Stewardship Program

Educational Based Anti-Microbial Stewardship Background: Traditionally, the hallmark of an anti-microbial stewardship program [ASP] has been restricting access to anti-bacterials. We believe that such a program does not promote a change in prescribing behavior. TeleMed2U and Ukiah Valley Medical Center [UVMC] have embarked on a telemedicine based ASP that is primary focused on provider education rather than ant-bacterial restriction. Methods: In 2013 UVMC initiated a telemedicine based ASP. The program involved a comprehensive review of current prescribing habits, the hospital anti-biogram and the anti-infective formulary. The ASP committee then developed treatment guidelines to offer providers various treatment options. In addition, the Infectious Diseases physician conducted a series of lectures to educate providers on the appropriate anti-bacterial treatment options. This education series included: noon conferences; hospitalist meetings and department meets Ð medicine, emergency medicine and surgery. Furthermore, daily telemedicine based ASP rounds occurred where anti-bacterial therapies for the last 24 hours were reviewed. When appropriate the attending physician was conducted to discuss alternative therapies, all while maintaining an open anti-infective formulary. Results: The impact of antibiotic stewardship in the first six months of this program was studied and compared that to 2012. In these six months, UVMC experienced a 1.4% reduction in antibiotic days. This was coupled by a savings in antibiotic cost of $16 per patient day, translating to a total of $93,072 saved in the first six months of this program. In 2014, the number of antibiotic days were further reduced by 2.3% and antibiotic cost decreased by an additional $27 per patient day. The overall result, versus 2012, has been a total reduction of $43 per patient day, translating to a savings of $267,417 in antibiotic costs at UVMC. Conclusion: The implementation of an education based ASP fostered true change in prescribing habits throughout the medical staff. By not restricting anti-bacterials providers were open to education and considering alternative treatment options. We believe that this model for ASP creates a collegial and constructive environment.