Application of Standardized Antimicrobial Administration Ratio as a Motivational Tool within a Multi-Hospital Healthcare System
The standardized antimicrobial administration ratio (SAAR) is a novel antimicrobial stewardship metric that compares actual to expected antimicrobial use (AU). This prospective cohort study examines the utility of SAAR reporting and inter-facility comparisons as a motivational tool to improve overal...
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doaj-88a2cab12cbf49638f4faf5fed852edd2021-02-08T00:02:00ZengMDPI AGPharmacy2226-47872021-02-019323210.3390/pharmacy9010032Application of Standardized Antimicrobial Administration Ratio as a Motivational Tool within a Multi-Hospital Healthcare SystemStephanie Shealy0Joseph Kohn1Emily Yongue2Casey Troficanto3P. Brandon Bookstaver4Julie Ann Justo5Hana R. Winders6Sangita Dash7Majdi N. Al-Hasan8Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, SC 29208, USADepartment of Clinical Pharmacy, Prisma Health–Midlands, Columbia, SC 29203, USADepartment of Clinical Pharmacy, Prisma Health–Midlands, Columbia, SC 29203, USADepartment of Clinical Pharmacy, Prisma Health–Midlands, Columbia, SC 29203, USADepartment of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, SC 29208, USADepartment of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, SC 29208, USADepartment of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, SC 29208, USADepartment of Medicine, Division of Infectious Diseases, University of South Carolina School of Medicine, Columbia, SC 29209, USADepartment of Medicine, Division of Infectious Diseases, University of South Carolina School of Medicine, Columbia, SC 29209, USAThe standardized antimicrobial administration ratio (SAAR) is a novel antimicrobial stewardship metric that compares actual to expected antimicrobial use (AU). This prospective cohort study examines the utility of SAAR reporting and inter-facility comparisons as a motivational tool to improve overall and broad-spectrum AU within a three-hospital healthcare system. Transparent inter-facility comparisons were deployed during system-wide antimicrobial stewardship meetings beginning in October 2017. Stakeholders were advised to interpret the results to foster competition and incorporate SAAR data into focused antimicrobial stewardship interventions. Student’s <i>t</i>-test was used to compare mean SAARs in the pre- (July 2017 through October 2017) and post-intervention periods (November 2017 through June 2019). The mean pre-intervention SAARs for hospitals A, B, and C were 0.69, 1.09, and 0.60, respectively. Hospital B experienced significant reductions in SAAR for overall AU (from 1.09 to 0.83; <i>p</i> < 0.001), broad-spectrum antimicrobials used for hospital-onset infections (from 1.36 to 0.81; <i>p</i> < 0.001), and agents used for resistant gram-positive infections in the intensive care units (from 1.27 to 0.72; <i>p</i> < 0.001) after the interventions. The alignment of the SAAR across the health-system and sustained reduction in overall and broad-spectrum AU through implementation of inter-facility comparisons demonstrate the utility in the motivational application of this antimicrobial use metric.https://www.mdpi.com/2226-4787/9/1/32antibioticsantimicrobial useantimicrobial stewardshipmetrics |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stephanie Shealy Joseph Kohn Emily Yongue Casey Troficanto P. Brandon Bookstaver Julie Ann Justo Hana R. Winders Sangita Dash Majdi N. Al-Hasan |
spellingShingle |
Stephanie Shealy Joseph Kohn Emily Yongue Casey Troficanto P. Brandon Bookstaver Julie Ann Justo Hana R. Winders Sangita Dash Majdi N. Al-Hasan Application of Standardized Antimicrobial Administration Ratio as a Motivational Tool within a Multi-Hospital Healthcare System Pharmacy antibiotics antimicrobial use antimicrobial stewardship metrics |
author_facet |
Stephanie Shealy Joseph Kohn Emily Yongue Casey Troficanto P. Brandon Bookstaver Julie Ann Justo Hana R. Winders Sangita Dash Majdi N. Al-Hasan |
author_sort |
Stephanie Shealy |
title |
Application of Standardized Antimicrobial Administration Ratio as a Motivational Tool within a Multi-Hospital Healthcare System |
title_short |
Application of Standardized Antimicrobial Administration Ratio as a Motivational Tool within a Multi-Hospital Healthcare System |
title_full |
Application of Standardized Antimicrobial Administration Ratio as a Motivational Tool within a Multi-Hospital Healthcare System |
title_fullStr |
Application of Standardized Antimicrobial Administration Ratio as a Motivational Tool within a Multi-Hospital Healthcare System |
title_full_unstemmed |
Application of Standardized Antimicrobial Administration Ratio as a Motivational Tool within a Multi-Hospital Healthcare System |
title_sort |
application of standardized antimicrobial administration ratio as a motivational tool within a multi-hospital healthcare system |
publisher |
MDPI AG |
series |
Pharmacy |
issn |
2226-4787 |
publishDate |
2021-02-01 |
description |
The standardized antimicrobial administration ratio (SAAR) is a novel antimicrobial stewardship metric that compares actual to expected antimicrobial use (AU). This prospective cohort study examines the utility of SAAR reporting and inter-facility comparisons as a motivational tool to improve overall and broad-spectrum AU within a three-hospital healthcare system. Transparent inter-facility comparisons were deployed during system-wide antimicrobial stewardship meetings beginning in October 2017. Stakeholders were advised to interpret the results to foster competition and incorporate SAAR data into focused antimicrobial stewardship interventions. Student’s <i>t</i>-test was used to compare mean SAARs in the pre- (July 2017 through October 2017) and post-intervention periods (November 2017 through June 2019). The mean pre-intervention SAARs for hospitals A, B, and C were 0.69, 1.09, and 0.60, respectively. Hospital B experienced significant reductions in SAAR for overall AU (from 1.09 to 0.83; <i>p</i> < 0.001), broad-spectrum antimicrobials used for hospital-onset infections (from 1.36 to 0.81; <i>p</i> < 0.001), and agents used for resistant gram-positive infections in the intensive care units (from 1.27 to 0.72; <i>p</i> < 0.001) after the interventions. The alignment of the SAAR across the health-system and sustained reduction in overall and broad-spectrum AU through implementation of inter-facility comparisons demonstrate the utility in the motivational application of this antimicrobial use metric. |
topic |
antibiotics antimicrobial use antimicrobial stewardship metrics |
url |
https://www.mdpi.com/2226-4787/9/1/32 |
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