Researchers developed a four-phase approach to implementing antimicrobial stewardship programs across a large system of community hospitals. Although each phase was implemented sequentially, facilities could progress at their own pace. The phases included preparatory, foundational, clinical care optimization and refinement. They conducted a survey in 2010, before using the approach, and surveys in 2015 and 2017.
The study shows stewardship activities improved in most areas of the antimicrobial stewardship program initiative. Important changes included an increase in established programs, from 82 percent in 2010 to 96 percent in 2017. Physician champions increased from 73 percent in 2010 to 94 percent in 2017. Total antibiotic spend decreased 40 percent from baseline with this initiative.
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