Nov 15, 2022 – Crystal (Pharm), Chloe Bryson-Cahn, MD, Natalia Martinez-Paz

Summary of AMS and key points

• CNO was running AMS before Crystal took over.
• How to make stewardship meaningful, rather than a checkbox
• 18 inpatient beds (8 – 10 census)
• 2 main hospitalists that cover ED, clinics, babies,
• Surgery has doubled in last year – hysterectomies, colonoscopies, cataract surgery
• Long term care – none directly affiliated. Have assisted living and swing beds
• EMR – EPIC
• NHSN – AU not reporting

Current barriers

• Former MD was high user of Levaquin but they left
• IV to PO

Current Wins for Core Elements

• Leadership – AMS Committee and leader and budget support for AMS
• Accountability – partnership with MDs
• Pharm Expertise – AMS PharmD lead
• Action – Prospective audit and feedback, UnityPoint One guidelines built into EPIC
• Tracking – Antibiogram, individual prescriber reports for ABX use
• Reporting – antibiogram every 6 months
• Education – Classes on HealthStreams once a year

Future Small Wins

• Strong bones of AMS program, time to finesse!
• Immediate small wins:
  • Next 3 – 6 months:
    • Leadership – AMS committee present to board
    • Accountability – IV to PO
    • Pharm Expertise – More classes!
    • Action – reducing UTI abx duration (12- 24 months)
    • Tracking – indications for ASB
    • Reporting – peer comparison opportunities
    • Education – Attend TASP