Integration of a Lean Daily Management System into an Antimicrobial Stewardship Program

Abstract

Introduction: Growing demands and limited guidance on efficient use of resources to advance stewardship initiatives challenge antimicrobial stewardship programs (ASP). Methods: The primary aim was to incorporate a Lean Readiness and Metrics Board (RMB) into ASP and assess team member accountability and satisfaction with weekly 15-minute huddle participation within 1 year of implementation. ASP team survey data were analyzed for comments regarding Lean integration, team communication, and productivity. The second aim was to develop 5 shared metrics associated with quality, people, delivery, safety, and stewardship and evaluate ASP team productivity by assessing the impact of projects targeted at each specific metric. Pharmacist-physician ASP scheduling conflicts were addressed through identified rounding times under the “People” metric. The “Quality” metric assessed ASP intervention disagreement rate and collaborations that occurred to reduce disagreement. ASP tracked the number of individuals educated by ASP monthly through the “Delivery” metric. Results: Since August 2018, ASP replaced hour-long monthly meetings with weekly huddles at the RMB. On average, 14 members (88%) of the ASP participate weekly. Team members report improvement in communication and satisfaction with Lean integration. Metric utilization enhanced productivity. For the metrics under “People,” “Quality,” and “Delivery,” reduced scheduling conflicts occurred, the ASP intervention disagreement rate decreased (37.0%–25.6%; P < 0.001), and the ASP educated an average of 79 learners per month. Conclusions: Weekly huddles at the RMB enhanced communication and team accountability while visually displaying program needs, progress, and achievements. The RMB helps to ensure ongoing institutional commitment, and Lean methods show promise for evaluating and improving ASP productivity.

Novel expansion of a well-established antimicrobial stewardship program: Enhancing program efficiency and reach

“…7 Our ASP consists of a large multidisciplinary team with organized efforts for project sharing and time management, yet team members still report challenges due to time constraints and competing priorities. 17 Improving efficiency and addressing challenges with our current PAF stewardship program was vital with program expansion.…”

Antimicrobial Stewardship and Improved Antibiotic Utilization in the Pediatric Cardiac Intensive Care Unit

“…[13][14][15][16] The rise of ASPs has led to improved antibiotic use, increased guideline compliance, decreased cost of care, and enhanced productivity. 14,15,17,18 Implementing ASPs in the CICU has unique challenges and requires a multidimensional approach, as these patients are medically complex with multiple stakeholders and require a tailored approach to antimicrobial prescribing. 19 We sought to decrease the unnecessary use of broad-spectrum antimicrobials in the CICU through targeted quality improvement (QI) interventions without compromising patient outcomes.…”

Detection of unusual scores of individual students for immediate remedy according to daily assessment data

“…It is a system that documents the processes related to a particular job and the plans for managing and improving operations (Cassidy, 1996). Daily management has been practiced not only in industries (Zarbo et al, 2015;Kennedy, 2019) but also in service sectors (Donnelly, 2014;Whitley et al, 2015;Hopkins et al, 2017;Wirtz et al, 2021).…”