1825. Improving Antimicrobial Use by Implementing the CDC Antimicrobial Stewardship Core Elements Across a Diverse Healthcare System
Session: Oral Abstract Session: Thinking Beyond Your Hospital: Stewardship on a Broader Scale
Saturday, October 7, 2017: 11:00 AM
Room: 01AB
Background: With increasing national focus on reducing inappropriate antimicrobial use, state and national regulatory mandates require hospitals to develop robust antimicrobial stewardship programs (ASP).

Methods: BJC HealthCare is a 13 hospital healthcare system serving the St. Louis, mid-Missouri, and Southern Illinois region and includes adult and pediatric academic medical centers, as well as community and critical access hospitals. In 2015, BJC system leaders engaged relevant clinical and executive stakeholders at each hospital to champion formation of a multidisciplinary system ASP Council. A comprehensive gap analysis was performed to assess current stewardship resources and activities. BJC system clinical leads facilitated the development of hospital specific leadership support statements, identification of hospital pharmacy and medical leaders, and all mandated educational components. To facilitate tracking, reporting and improvement activities, a robust antimicrobial use data dashboard was created. Each hospital has a dedicated ASP team that is supported by the system clinical leads. Hospital learnings are shared at monthly system ASP meetings allowing for broad dissemination.

Results: By leveraging system resources, all 13 BJC HealthCare hospitals met all Joint Commission requirements by January 2017. BJC’s model of ASP allows for the development of broad-based stewardship activities including development of education modules for patients and providers, and clinical decision support tools while allowing individual hospitals to implement activities based on local needs and resource availability. Local hospital teams have developed treatment guidelines, targeted antibiotic pharmacy review, “handshake” stewardship models, and allergy testing protocols. Central support of local hospital ASP has resulted in a 7.6% system decrease in tracked antimicrobial use, including a 16.5% reduction in quinolone usage. Additionally, the C. difficile standardized infection ratio decreased from 1.08 to 0.622 since program initiation.

Conclusion: Despite significant differences in hospital resources, a system-supported ASP model focused on implementing the CDC core elements can result in significant reductions in antimicrobial use.

Michael Lane, MD, MPHS, MSc1,2, Amanda Hays, PharmD., MHA, BCPS1, Helen Newland, PharmD1, Jeanne Zack, PhD RN CIC1 and Jason Newland, MD, MEd, FPIDS1,3, (1)Center for Clinical Excellence, BJC HealthCare, St. Louis, MO, (2)Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, (3)Division of Pediatric Infectious Diseases, Washington University School of Medicine in St. Louis, St. Louis, MO


M. Lane, None

A. Hays, None

H. Newland, None

J. Zack, None

J. Newland, Merck: Grant Investigator , Research grant
Allergan: Grant Investigator , Research grant

Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.