August 25, 2022 – Researchers at Intermountain Healthcare have conducted a landmark, first-of-its-kind survey to identify and stratify antimicrobial stewardship programs into four different groups – a first step toward studying the effectiveness of these models to best enhance patient care and reduce the rise of antibiotic resistant superbugs.
Antimicrobial stewardship programs are a vital way for hospitals and healthcare systems to ensure that antibiotics are being appropriately used. If they keep being given to patients who don’t need them, they can harm those patients while also contributing to antibiotic resistance, thus making bacterial infections harder to treat.
The study, led by Intermountain researchers in collaboration with scientists from Pew Charitable Trusts and University of Utah Health, surveyed 20 different healthcare systems, including Kaiser Permanente, the Mayo Clinic and Veterans Health Administration.
As part of the national survey, program leaders were asked about things like key aspects of their system or network’s current antibiotic stewardship structure and function. Researchers also conducted a webinar, virtual breakout group discussions and focus groups, which gave them more information about these antimicrobial stewardship programs, and also prompted leaders in this field to start conversations with each other about their work.
Researchers found four categories of programs exist in the United States:
- Collaborative Model (15%): These programs developed organically with no formal structure and are run by committees with limited accountability. Through this model, participation by sites is voluntary, and antimicrobial stewardship goals are set by individual sites, rather than at the system level.
- Centrally Coordinated Model (30%): These programs have a formal written structure and committee with some level of system accountability. This model often forms organically at first but also has committee-led system stewardship initiatives, systemwide goals coordinated through a central committee (and may be augmented by local goals), data resources that are often prioritized by the committee.
- Centrally Led Model (40%): These programs have a formal system of antimicrobial stewardship leaders, and system accountability with system-level resources. Goals are set by leaders at the system level (and may be augmented by local goals), with system leaders responsible for standardized data across all sites, and with benchmarking prioritized.
- Collaborative, Consultative Network Model (10%): These program, where antimicrobial stewardship leaders outside the organization serve as consultants, mentors, or members in collaboration with on-site leaders, allow sites to participate in and receive support from a network. This model also has site-specific mentoring, goals, stewardship and tools adopted from external sites; data technology and communication developed locally or through the system’s network; and subject-matter expertise and education provided by external leaders as well.