Handshake Stewardship: Interdisciplinary Rounds as a Tool to Spread Antimicrobial Stewardship Led by Hospitalist-Pharmacist Teams

Abstract

Background Over the past decade there has been a greater emphasis on optimizing antimicrobial stewardship. Most stewardship models rely upon a central team, often led by infectious disease doctors and pharmacists to oversee institutional prescribing. We believe there is opportunity to complement this model by incorporating stewardship into interdisciplinary rounds.ObjectiveTo access feasibility and acceptance of antimicrobial stewardship into interdisciplinary rounds.Method We piloted a stewardship model driven by hospitalists and pharmacists through interdisciplinary rounds on four medicine units. We hypothesized that our process would not hamper existing tasks of interdisciplinary rounds. We surveyed team members to understand how the initiative was experienced.ResultsMany clinicians reported that antimicrobial prescribing was ‘often’ or ‘always’ discussed, and the process was ‘not too burdensome’ to incorporate. These responses varied based on the type of provider. A majority of the advanced practice providers (88%) reported the model prompted them to reconsider their individual antimicrobial prescribing. A 28.1% overall reduction of target antibiotic utilization was realized, however, there may be other contributors to this reduction.ConclusionWe believe interdisciplinary rounds can provide a good platform to extend hospital-based antimicrobial stewardship. It was not felt to disrupt the efficiency of achieving other goals of interdisciplinary rounds.

Antimicrobial Stewardship Intervention Before and During The COVID-19 Pandemic in the Acute Care Settings: A Systematic Review

“…Pharmacists also have an essential role in the interdisciplinary rounds (IDR) [44], which enable them to review patients prescribed antibiotics using the electronic medical record, in addition to monitoring the antibiotics used, culture results, and therapy duration. The involvement of pharmacists in the multidisciplinary meetings and leading AMS was so helpful [45]. Pharmacists working in collaboration with other health care professionals have an essential role in the global mandate of AMS implementation.…”