| Intervention Type1,2 |
Process/Monitoring |
Possible Antibiotic Use Measures To Access Impact |
Additional Measures, Including Benefits/Unintended Consequence |
|---|
| Formulary changes, restrictions, and preauthorization |
- Number of calls/requests for restricted drug (changes over time).
- Percentage of requests approved (over time by staff).
- Number of formal Infectious Diseases consultations.
|
- Total number of courses or patients on restricted antibiotics, alternative antibiotics to the restricted drug.
- Defined daily doses.
|
- Time to receipt of antibiotics (delays).
- Number of doses dropped/missed.
- Antibiotic costs.
|
| Audit and feedback to providers |
- Number of patients who met criteria for auditing, reviewed, advice given, intervention made, and advice accepted.
- Number of formal Infectious Diseases consultations.
|
- Days of therapy for antibiotics and total patients on redundant antibiotic combinations.
- Defined daily doses.
|
- Length of stay.
- Clinical failure—reinstitution of broad antibiotic regimens.
- Readmissions.
- Antibiotic costs.
|
| Flow and algorithms for empiric and streamlined regimens for specific diagnoses or pathogens |
- Web hits for educational pages with algorithms.
- Educational assessment of understanding of guidelines.
- By limited chart/patient review—percentage of patients receiving/tailoring antibiotics per protocols.
|
- Total number of patients with syndrome or diagnosis on appropriate antibiotics (may have external validated measure such as Centers for Medicare & Medicaid Systems [CMS] core measures, e.g., pneumonia).
- Total number of courses or patients on antibiotics and duration of antibiotics involved in protocol.
|
- Length of stay.
- Readmissions.
|
| Antibiotic order forms and automatic stop orders |
- Number of patients per month where antibiotic form used.
- By limited review—percentage of patients where antibiotic order form was used, e.g., to continue or stop antibiotics.
|
- Total number of patients with syndrome or diagnosis on appropriate antibiotics or for appropriate length (may have external validated measure such as CMS core measures for surgical prophylaxis).
- Total number of courses or patients on antibiotics and duration of antibiotics involved in the automatic orders (may be by service, prescriber, patient population, or forms/order).
|
|
| Novel approaches to use of technology and stewardship staff |
- Will depend on nature of intervention.
- Number of calls, requests, or interventions by specific staff (percentage acceptance rates).
- Number of patients per month/timeframe where technology used.
|
- Will depend on nature of intervention.
- Comparison of specific antibiotic courses before and after intervention.
|
- Will depend on nature of intervention.
|
| Educational component for clinicians and patients |
- Number of educational programs.
- Number of attendees.
- Survey of attitudes or understanding about prescribing topic.
|
- Will depend on nature of education.
- Total number of courses or patients on antibiotics and duration of antibiotics involved.
|
- Improved visibility of program.
- Collaborative care or camaraderie with other services.
- Possible exchange of ideas about processes and choice of therapy.
|
