1. Blanchard Valley Health System Antimicrobial Stewardship Program
Caring for a Lifetime
Extraordinary people. Exceptional Care

2. Culture
Requires clear support from Senior Leadership including financial investment
Strive for a culture that supports
Exceptional clinical care
Exceptional patient experience
Zero patient harm

3. History Pharmacy reviews begin in 2005
Formalized process approved by medical staff in 2009
The Joint Commission Standard - January 1, 2017
Today:
Infectious disease physician
Clinical pharmacist(s) (PharmD)
Pharmacy students/residents
Microbiologist
Infection preventionist
Adult hospitalists

4. Process
Pharmacists review all antibiotic orders daily for prophylaxis, treatment, switches, and kidney function
Consult with Infectious disease specialist
Formal meetings
Infection control monitors for outbreaks
Microbiology resistance patterns (antibiograms)
Medication optimization
Right drug for right bug
Right dose
Minimize drug interaction

5. Outcomes
Expensive antibiotics not utilized without ID consult. FY17 = zero use
Recommendations made, currently 95% accepted.
Patient days of antibiotics reviewed = 2,000+ patient days per month
Integration with community-based care
Intra-operative antibiotic dosing/longer duration
C. Difficile: Probiotics and Root Cause Analysis

6. Next Steps
Rapid molecular testing to shorten diagnostic timeframe
Contacts
Colleen Abrams, BVHS Infection Preventionist
Mike Leifheit, BVHS Pharmacist 1.