For hospitals, funding often poses the most significant barrier to implementing an antimicrobial stewardship program. With so many competing priorities, it can be hard for senior administrators to focus their attention; many programs remain hobbled after implementation by budgets that simply do not allow them to succeed. While every program must work within its hospital’s overall budget, antimicrobial stewardship advocates can increase the chances for success by avoiding four errors often made when applying for funding: 1
1. Not calling in the big guns: Start your appeal for funds with medical grant rounds from a recognized expert in antimicrobial stewardship. Local and regional authorities will be eager to support your efforts and frequently national or international leaders can be persuaded to share their expertise to launch a new antimicrobial stewardship program (ASP). Don’t forget to enlist the help of supportive leaders within your facility, too.
2. Underbudgeting: There will be surprises. Build in a 20% contingency for overruns, unexpected expenses and forgotten line items. If you try to work with a bare bones budget, or one you know is less than you’ll need, you are setting the program up to fail.
3. Overpromising: You want to be in the position to overperform rather than underdeliver, so manage expectations upfront. Many programs save their hospitals significant money in pharmaceutical costs, reduced lengths of stay, avoided complications and improved patient safety and quality of care, but you may not be able to predict how much your program will save until you have all the elements in place and have gained widespread acceptance among prescribers and administrators. Set modest goals you can confidently achieve.
4. Failing to look at all funding sources: Start with your hospital administration and demonstrate how an antimicrobial stewardship program will help meet existing priorities such as reduced rates of healthcare-associated infections, improved care and enhanced quality. Also consider going to the hospital’s foundation.
Federal and state agencies are also interested in healthcare cost-savings or quality improvement. For example, California has launched an Antimicrobial Stewardship Program Collaborative that may be able to help hospitals in the state keep costs down by sharing best practices and identifying additional ways to secure funding.2 Technology and pharmaceutical companies may also be able help defray some costs. Consider sourcing additional staff or IT support from local colleges or graduate programs.
1. Morris, A. The Business of Antimicrobial Stewardship. PowerPoint. Antimicrobial Stewardship Program, Mt. Sinai Hospital/University Health Network.
2. California Department of Public Health. The California Antimicrobial Stewardship Program Initiative. http://www.cdph.ca.gov/programs/hai/Pages/AntimicrobialStewardshipProgramInitiative.aspx