A Multidisciplinary Hospital‐based Antimicrobial Use Program: Impact on Hospital Pharmacy Expenditures and Drug Use

Salama, Samih; Rotstein, Coleman; Mandell, Lionel A.

doi:10.1155/1996/685704

Cited by 20 publications

(27 citation statements)

References 28 publications

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“…Antibiotics are also very expensive. They account for about 30% of a typical hospital's pharmacy budget [16]. Thus, overuse of antibiotics leads to increased morbidity in patients and excess cost.…”

Section: Case Study: Reducing Antibiotic Resistant Infectionsmentioning

confidence: 99%

Towards Model-Based Support for Managing Organizational Transformation

Barone

Peyton

Rizzolo

et al. 2011

Lecture Notes in Business Information Processing

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Abstract. In an increasingly connected and dynamic world, most organizations are continuously evolving their business objectives, processes and operations through ongoing transformation and renewal, while their external environment is changing simultaneously. In such a setting, it is imperative for organizations to continuously monitor their performance and adjust when there is a need. The technology that delivers this monitoring capability is called Business Intelligence (BI), and over the years it has come to play a central role in business operations and governance. Unfortunately, there is a huge cognitive gap between the strategic business level view of goals, processes, and performance on one hand, and the technological/implementation view of databases, networks, and computational processing offered by BI tools on the other.In this paper, we present a model-based framework for bridging this cognitive gap and demonstrate its usefulness through a case study involving organizational transformation. The business view is modeled in terms of the Business Intelligence Model (BIM), while the data collection and reporting infrastructure is expressed in terms of the Conceptual Integration Model (CIM). The case study involves a hospital implementing a strategic initiative to reduce antibiotic resistant infections.

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Section: Case Study: Reducing Antibiotic Resistant Infectionsmentioning

confidence: 99%

Towards Model-Based Support for Managing Organizational Transformation

Barone

Peyton

Rizzolo

et al. 2011

Lecture Notes in Business Information Processing

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“…However, because of the perception that antimicrobial agents are associated with low risk of toxicity, these therapeutic drugs have resulted in varying degrees of inappropriate use (5-13). Therefore, it is not surprising that these drugs have received increasing scrutiny during an era of cost containment (14,15).Surgical site infections account for up to 24% of nosocomial infections (16). Consequences of these infections include compromised quality of life for patients and significant treatment expenditures.…”

mentioning

confidence: 99%

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confidence: 99%

“…Strategies to limit the inappropriate drug use in the hospital setting include the following methods: educational activities for physicians (36,37) such as Pharmacy and Therapeutics Committee newsletters or inservices (38); peer review (39); academic detailing (40); an antibiotic handbook (2,41,42); a controlled formulary system (15,43); automatic stop order policies (43); drug detailing by pharmaceutical representatives (44); infectious disease specialist consultations (43); therapeutic interchange policies (14,15); and a preprinted antimicrobial order form (2,43,(45)(46)(47)(48). These methods have met with varying degrees of success (2)(3)(4)14,15), but in general, the most successful and lasting effects have been recorded through prescribing restrictions when an order form or computer-assisted decision support is employed.…”

mentioning

confidence: 99%

“…These methods have met with varying degrees of success (2)(3)(4)14,15), but in general, the most successful and lasting effects have been recorded through prescribing restrictions when an order form or computer-assisted decision support is employed. In addition, an order form may serve as an educational tool for residents and may be an effective quality assurance item to monitor the use of antimicrobial agents.…”

mentioning

confidence: 99%

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Implementation and Evaluation of a Preprinted Perioperative Antimicrobial Prophylaxis Order Form in a Teaching Hospital

Au¹,

Salama

Rotstein³

1998

Canadian Journal of Infectious Diseases and Medical Microbiolog

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P Au, S Salama, C Rotstein. Implementation and evaluation of a preprinted perioperative antimicrobial prophylaxis order form in a teaching hospital. Can J Infect Dis 1998;9(3):157-166. OBJECTIVE:To determine the effect of a preprinted perioperative antimicrobial prophylaxis order form on the appropriateness, standardization and cost of surgical prophylaxis. DESIGN: A pre-and postintervention prospective study with evaluation of drug acquisition costs in selected surgical procedures. SETTING: A 420-bed teaching hospital in the Hamilton-Wentworth region. PATIENTS: A three-month survey of 901 consecutive patients followed by a two-month trial period of 725 consecutive patients undergoing general surgery, orthopedic and urological procedures. INTERVENTION: A perioperative antimicrobial prophylaxis order form was developed based on guidelines from the literature and input from physician and nursing staff. The form was introduced through educational inservices and put into operation. MEASUREMENT: The measurement of antimicrobial perioperative prophylaxis appropriateness and drug acquisition costs were assessed pre-and postintroduction of the order form. Subsequently, prescriber compliance and satisfaction with the program were also evaluated. RESULTS: Appropriateness of perioperative antimicrobial surgical prophylaxis was increased from 36% in the baseline period to 79% in the trial period (P<0.0001). A reduction of $440.71 ($23.20/procedure) in drug acquisition costs was observed for 19 matched hip and knee prosthetic surgical procedures between the baseline and trial periods. In addition, compliance with the perioperative order form rose steadily during the trial period. Physician prescribers reported that the form was used, and was appropriate and user-friendly but that it did not influence their prescribing habits. Nurses responded that the form was helpful and improved the timing of prophylaxis. CONCLUSIONS: The perioperative antimicrobial prophylaxis order form standardized antimicrobial administration time and resulted in an increase in appropriateness. A reduction in antimicrobial costs for surgical procedures was realized. This quality improvement project has enhanced the quality of patient care.Key Words: Antimicrobial therapy, Order form, Perioperative, Prophylaxis voir page suivante P rescription drugs contribute significantly to hospital expenditures and account for approximately 5% to 20% of a hospital's global budget (1). Antimicrobial agents constitute a substantial proportion of a hospital's drug inventory (about 25%) (2) and drug acquisition budget (20% to 50%) (3,4). However, because of the perception that antimicrobial agents are associated with low risk of toxicity, these therapeutic drugs have resulted in varying degrees of inappropriate use (5-13). Therefore, it is not surprising that these drugs have received increasing scrutiny during an era of cost containment (14,15).Surgical site infections account for up to 24% of nosocomial infections (16). Consequences of these infections include comprom...

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