968. How Ready Are Hospitals to Meet The Centers for Medicare & Medicaid Antibiotic Stewardship Requirements?
Session: Poster Abstract Session: Antibiotic Stewardship: General Acute Care Implementation and Outcomes
Friday, October 28, 2016
Room: Poster Hall

Background: The Centers for Medicare & Medicaid Services (CMS) have expanded the infection control section of their hospital survey to include questions on antimicrobial stewardship programs (ASPs). The objective of this study is to assess factors associated with readiness in meeting survey requirements.

Methods: Vizient hospitals (not-for-profit academic medical center (AMC) and community hospitals) were surveyed in March 2016 via the Vizient ASP list-serve [n= 446 hospitals] regarding ASP characteristics and whether 5 survey requirements were met including: written ASP support from leadership; designated ASP leader; documentation of antibiotic indication/duration by providers; assessment of antibiotic appropriateness; antibiotic use monitoring. To compare characteristics between those meeting the majority of requirements and those not, chi-square tests were used.

Results: Among 207 hospitals, most common facility type was AMCs (36%), followed by medium sized community hospitals (22%), and 64% were part of a system. A total of 83% report having an ASP, with most common duration of < 3 years (yrs) (33%). A total of 5% did not meet any requirements, 10% met 1, 20% met 2, 39% met 3, 23% met 4, and 3% met all 5. The percentage of hospitals meeting specific requirements is in Figure 1. Of those who had an ASP leader, 73% had physicians (60% with ID fellowship training), 88% a pharmacy leader, and 71% had both. There were significant differences (p < 0.05) between hospitals that met 4-5 vs. 0-3 requirements. Differences include hospital type and systems, with 13% of AMCs, 6% of large and medium sized, and 1% of < 100 bed and critical access hospitals meeting 4-5 requirements. Additionally 5% of non-system vs. 21% of system members met 4-5 requirements. Regarding duration, there were significant differences, with 1% of hospitals having an ASP for < 1yr, 7% 1-3 yrs, 10% 4-9 yrs, and 8% > 10 yrs meeting 4-5 requirements.

Conclusion: The majority of hospitals are not meeting all requirements, with one-third meeting two or less. Study of the practices and resources of hospitals that met 4-5 requirements can share implementation in hospitals with fewer met requirements. Priority should be placed on antibiotic indication and appropriateness requirements.

Shaina Bernard, PharmD, BCPS1, Amy Pakyz, PharmD, MS, PhD2, Kristi Kuper, PharmD, BCPS3, Natalie Nguyen, PharmD, MSHA1 and Michael Stevens, MD, MPH4, (1)Virginia Commonwealth University Medical Center, Richmond, VA, (2)Virginia Commonwealth University, Richmond, VA, (3)Vizient, Irving, TX, (4)Infectious Diseases, Virginia Commonwealth University, Richmond, VA


S. Bernard, None

A. Pakyz, None

K. Kuper, None

N. Nguyen, None

M. Stevens, None

Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.