TY - JOUR
T1 - Customizing an electronic medical record to automate the workflow and tracking of an antimicrobial stewardship program
AU - Katzman, Michael
AU - Kim, Jihye
AU - Lesher, Mark D.
AU - Hale, Cory M.
AU - McSherry, George D.
AU - Loser, Matthew F.
AU - Ward, Michael A.
AU - Glasser, Frendy D.
N1 - Publisher Copyright:
© The Author(s) 2019.
PY - 2019/6/3
Y1 - 2019/6/3
N2 - Background. Documenting the actions and effects of an antimicrobial stewardship program (ASP) is essential for quality improvement and support by hospital leadership. Thus, our ASP tallies the number of charts reviewed, types of recommendations, how and to whom they were communicated, whether they were followed, and any effects on antimicrobial days of therapy. Here we describe how we customized the electronic medical record at our institution to facilitate our workflow and data analysis, while highlighting principles that should be adaptable to other ASPs. Methods. The documentation system involves the creation of a novel and intuitive ASP form in each chart reviewed and 2 mutually exclusive tracking systems: 1 for active forms to facilitate the daily ASP workflow and 1 for finalized forms to generate cumulative reports. The ASP form is created by the ASP pharmacist, edited by the ASP physician, reopened by the pharmacist to assess whether the recommendation was followed and to quantify any antimicrobial days avoided or added, then reviewed and finalized by the ASP physician. Active forms are visible on a real-time “MPage,” whereas all finalized forms are compiled nightly into 65 informative tables and associated graphs. Results and Conclusions. This system and its underlying principles have automated much of the documentation, facilitated follow-up of interventions, improved the completeness and validity of recorded data and analysis, enabled our ASP to expand its activities, and been associated with decreased antimicrobial usage, drug resistance, and Clostridioides difficile infections.
AB - Background. Documenting the actions and effects of an antimicrobial stewardship program (ASP) is essential for quality improvement and support by hospital leadership. Thus, our ASP tallies the number of charts reviewed, types of recommendations, how and to whom they were communicated, whether they were followed, and any effects on antimicrobial days of therapy. Here we describe how we customized the electronic medical record at our institution to facilitate our workflow and data analysis, while highlighting principles that should be adaptable to other ASPs. Methods. The documentation system involves the creation of a novel and intuitive ASP form in each chart reviewed and 2 mutually exclusive tracking systems: 1 for active forms to facilitate the daily ASP workflow and 1 for finalized forms to generate cumulative reports. The ASP form is created by the ASP pharmacist, edited by the ASP physician, reopened by the pharmacist to assess whether the recommendation was followed and to quantify any antimicrobial days avoided or added, then reviewed and finalized by the ASP physician. Active forms are visible on a real-time “MPage,” whereas all finalized forms are compiled nightly into 65 informative tables and associated graphs. Results and Conclusions. This system and its underlying principles have automated much of the documentation, facilitated follow-up of interventions, improved the completeness and validity of recorded data and analysis, enabled our ASP to expand its activities, and been associated with decreased antimicrobial usage, drug resistance, and Clostridioides difficile infections.
UR - http://www.scopus.com/inward/record.url?scp=85078060547&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85078060547&partnerID=8YFLogxK
U2 - 10.1093/ofid/ofz352
DO - 10.1093/ofid/ofz352
M3 - Article
C2 - 31375823
AN - SCOPUS:85078060547
SN - 2328-8957
VL - 6
SP - 1
EP - 9
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 8
ER -