1867. A Regional Collaboration to Share Antimicrobial Stewardship Resources in Three Geographically Related Veterans Affairs Medical Centers
Session: Poster Abstract Session: Antimicrobial Stewardship: Potpourri
Saturday, October 6, 2018
Room: S Poster Hall

Antibiotic Stewardship (AS) programs are tasked with monitoring the use of antimicrobial agents across a variety of clinical settings. Most medical centers work independently, developing their own programs and using various clinical surveillance systems (CSSs) to identify intervention opportunities and monitor metrics. Geographically related medical centers may share patients and similar environments, and could benefit from working collaboratively to share knowledge and resources.


The AS programs were assessed at three Veterans Affairs Medical Centers (VAMCs) in three neighboring states (DC, MD and WV) over 2016 and 2017. The AS programs cover 350 acute care beds and 422 long-term care (LTC)/rehab beds. Each AS team has one infectious disease physician and one pharmacist. A SharePoint site was developed; meetings and teleconferences were held regularly. By way of a shared contract, a CSS (Theradoc, DSS Inc.) was installed at all three VAMCs between 11/2015 and 3/2016. Within TheraDoc, each AS program designed alerts and interventions specific to its own medical center and collaborated to develop a group of 22 interventions that were shared by all sites. There was no attempt to alter individually determined AS practices of each VAMC.


The table demonstrates the combined AS team interventions and aggregate cost-saving generated by the shared CSS. The number of interventions and the hours spent in CSS varied between centers; the top five most heavily conducted interventions differed between sites. Over time, new interventions developed at one VAMC were adopted at one or more of the other VAMCs at the discretion of the respective AS teams. Within a short period of time the cost-savings generated exceeded the CSS start-up investment.

CY 2016

CY 2017


AS Interventions




Time spent AS PharmDs (hours)




Time Spent AS MD (hours)




Cost Savings





Working collaboratively allowed each VAMC to leverage shared resources. Each AS program was able to adapt to its VAMC’s specific needs, while also demonstrating significant aggregate cost savings as a result of coordinated and defined AS activities.

Ann Laake, MD, Medicine, Martinsburg Veterans Affairs Medical Center, Martinsburg, WV; Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, Jacqueline Bork, MD, Veterans Affairs Maryland Health Care System-Baltimore, Baltimore, MD; Division of Infectious Diseases, University of Maryland School of Medicine, Division of Infectious Diseases, Baltimore, MD, Rohini Dave, PharmD, Veterans Affairs Maryland Health Care System, Baltimore, MD, Ayne Adenew, PharmD, Veterans Affairs Medical Center, Washington, DC, Heather Seitzinger, PharmD, Martinsburg Veterans Affairs Medical Center, Martinsburg, WV, Matt Zuzick, PharmD, Document Storage System Incorporated, Juno Beach, FL, James Chang, PharmD, Document Storage Service Incorporated, Juno Beach, FL and Angelike P. Liappis, MD, FIDSA, Washington DC Veterans Affairs Medical Center and The George Washington University Medical Center, Washington, DC


A. Laake, None

J. Bork, None

R. Dave, None

A. Adenew, None

H. Seitzinger, None

M. Zuzick, Document Storage Systems: Employee , Salary .

J. Chang, Document Storage Systems: Employee , Salary .

A. P. Liappis, None

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