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Toolkit for Reduction of Clostridium difficile Infections Through Antimicrobial Stewardship

Tools and Resources

Purpose: To help assess systems currently in place and ability to maintain and sustain ASP over time.

Source: ERASE C. difficile Project team.

Instructions: Complete checklist, review responses to ascertain the level of leadership support, and consider which areas need strengthening to move forward.

1. Will our current ASP staffing work on an ongoing basis?

How well is your stewardship team working across departments and disciplines? What is the current distribution of responsibilities? Do you need to make changes?
Action/remedy/plan if needed:
Who are the staff dedicated to [and $ supported] for ASP?List Staff:

Is this sustainable?
___ yes ___ no
If Yes, describe:

If No, what is the plan to make it sustainable?
What is the rotation/schedule for residents and fellows?Describe:

Is this sustainable?
___ yes ___ no
If Yes, describe:

If No, what is the plan?

 
Is our ASP hospital wide?___ yes ___ no

If No, describe the scope of the program:

 
If No, describe where implemented:

 
How do we maintain inter-disciplinary communication?Describe processes [committees, meetings, etc.]:

 
What are ASP members' responsibilities?Describe:

 
Is the distribution of responsibilities fair?___ yes ___ noIf No, describe changes needed:

 
Do we need to make changes?___ yes ___ noIf Yes, describe changes needed:

 
2. What is the plan for ongoing measurement and feedback?

A plan is only as good as the systems in place that ensure sustainability. It is crucial to plan at the onset for ongoing monitoring, maintenance, and evaluation of the ASP for reducing C. difficile
Action/remedy/plan if needed:
Do we have a plan for monitoring of the ASP?___ yes ___ no

If Yes, describe:

 
If No, what should the plan be?
Do we have a plan for maintenance of the ASP?___ yes ___ no

If Yes, describe:

 
If No, what should the plan be?
Do we have a plan for evaluation of the ASP?___ yes ___ no

If Yes, describe:

 
If No, what should the plan be?
Are our data in a workable format?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to obtain?
What are our current IT systems, staffing, and capabilities?Describe:

 
Do we have appropriate IT software?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to obtain?
3. What ongoing organizational support will be needed to keep the new ASP practices in place?

Maintaining your ASP requires organizational support on multiple levels. Ongoing organizational support for ASP for reducing C. difficile will be strongest if you can demonstrate that it is aligned with the medical center's strategic priorities and that it addresses pressing problems.
Action/remedy/plan if needed:
Is there organizational support for ASP?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to obtain?
Do we have the resources to maintain adequate and dedicated ASP staffing?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to obtain?
Do we have the appropriate IT support to produce the most useful data?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to obtain?
Do we have educational opportunities and forums to keep staff current on our ASP practices?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to provide?
Do we have systems in place to maintain best practices for ASP?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to maintain?
Do we have clinical leadership support for ASP?___ yes ___ no

If Yes, describe:
If No, what is the plan to obtain?
Do we have medical center leadership for ASP?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to obtain?
Does ASP fit in the hospital's overall-strategic planning?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to include ASP in strategic planning?
4. How do we develop an effective business case?

Given the environment of tightening resources in most medical centers, you will likely need to make a strong business case for continued or expanded investment in your ASP to include C. difficile.
Action/remedy/plan if needed:
Are there financial barriers to implementing ASP?___ yes ___ noIf Yes, describe:

 
Do we have a good estimate of cost savings realized through full implementation of ASP?___ yes ___ no

If Yes, describe the scope of the program:

 
If No, what is the plan to obtain estimates?
Have we calculated anticipated savings?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to obtain?
Have we calculated actual savings?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to calculate?
Do we have a description of how ASP activities translate into cost savings?___ yes ___ no

If Yes, describe:

 
If No what is the plan to create a description?
Do we have a description of how improved patient outcomes bring about cost savings?___ yes ___ no

If Yes, describe:

 
If No, what is the plan to create a description?

Please note: The following three tools are examples developed by facilities participating in the ERASE C. difficile Project to implement interventions.

Return to Question 4

Page last reviewed September 2012
Internet Citation: Toolkit for Reduction of Clostridium difficile Infections Through Antimicrobial Stewardship: Tools and Resources. September 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/cdifftoolkit/cdiffl2tools4a.html