Successful antimicrobial stewardship programs (ASPs) improve patient outcomes and hospital finances. According to the CDC, improved antibiotic prescription practices associated with ASPs reduce rates of multidrug resistant organisms (MDROs) in hospitals and improve clinical outcomes for patients.1 Reducing use of just the antibiotics most associated with C. difficile by 30% would cut C. difficile rates by 26% or about 60,000 cases per year and would save more than 3,000 lives annually nationwide.2
On a hospital level, facilities that implement comprehensive ASPs consistently save $200,000 to $900,000 per year.3 Antimicrobial stewardship programs dramatically reduce drug costs by eliminating unnecessary prescriptions, keeping days of treatment to the shortest effective period and minimizing duplicative prescriptions. They also shorten patient length of stays by reducing healthcare associated infections (HAIs): On average, an HAI leads to 9.58 extra hospital days and $38,656 in largely unreimbursable excess charges.4
Across the country, hospitals have realized notable gains in their ASP programs by leveraging advanced surveillance technology.
Three years after implementing an ASP, one 300-bed community hospital in north central Texas:
- Documented antimicrobial activity increases of more than 750%.
- Reduced defined daily dose (DDD) by 3% in a one-year period.
- Cut days of therapy (DOT) by 3.9% in a one-year period.
- Decreased antibiotic costs per patient day (case mix index adjusted) by more than 35%.
A 135-bed hospital in North Carolina realized an overall increase in pharmacy interventions (including ASP interventions) from hundreds to thousands within the first seven weeks of implementing a sophisticated surveillance program. Cost avoidance numbers ranged from $3 million to $4 million monthly.
The hospitals achieved these results with electronic surveillance technology that enables pharmacists to prospectively audit prescriptions, helps infection preventionists quickly identify MDROs, allows hospital epidemiologists to detect an outbreak before it gets out of hand, and simplifies reporting to management, as well as state and federal agencies.
Sophisticated surveillance programs aggregate patient data from multiple sources—including pharmacy, A/D/T, labs, microbiology and the electronic medical record—to permit real-time tracking and identification of potential antimicrobial issues. Automated alerts to clinicians help eliminate delays in communication and analysis, while customized filters avoid alert fatigue. Hospitals can enable immediate notification of orders for restricted antimicrobials, comparisons of antimicrobial regimens, drug-bug mismatches, renal function surveillance, patient allergy or drug-drug interaction risks and potential HAIs.
Because electronic surveillance programs allow clinicians to head off potential problems before they have a chance to escalate, they increase the effectiveness of ASPs. And successful programs boost hospitals’ financial performance while improving patient care and the health of their surrounding communities. By implementing a comprehensive ASP, you can boost your bottom line and reduce the emergence of MDROs in your hospital.
1. CDC. Get Smart for Healthcare: Know When Antibiotics Work. National Center for Emerging and Zoonotic Infectious Disease. Division of Healthcare Quality Promotion.
2. Fridkin S, Baggs J, Fagan R, et al. Vital signs: improving antibiotic use among hospitalized patients. MMWR Morb Mortal Wkly Rep. Mar 7 2014;63(9):194-200.
3. IDSA/SHEA Guidelines for Antimicrobial Stewardship Programs
4. Zhan C, Miller MR. Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization. JAMA 2003;290:1868-74.