In this article an infectious diseases pharmacist with over a decade of experience in the field outlines five secrets for how to run a successful antimicrobial stewardship program.
Authored By: Timothy P. Gauthier, Pharm.D., BCPS, BCIDP
Article Posted 12 September 2021
Since graduating from my PGY2 infectious diseases training program in 2010 I have had the opportunity to work in the field of antimicrobial stewardship as a researcher, educator, front-line clinician, and program manager. Through this website I have had the opportunity to connect with hundreds of people and in particular the articles about antimicrobial stewardship across the world have offered a great opportunity for obtaining key insights.
For those who champion antimicrobial stewardship programs, the ultimate goal is to enhance the safety and appropriateness of antimicrobial drugs use. However, the way one defines success can vary significantly. In pursuing goals, there are many things to be aware of and it frequently is more about succeeding in the journey than finding success at an ultimate destination.
To share insights on how to find success in the field of antimicrobial stewardship, I offer the following. In this article five secrets for how to run a successful antimicrobial stewardship program are discussed.
1. Make Relationships a Priority
This is number one on the list for a reason. It is THE key to success in the field of antimicrobial stewardship.
Improving antimicrobial use practices often requires making changes to the current systems and workflows. Over and over again I have found that if you want to change things, you need the support of other people. That can include physicians, pharmacists, administrators, laboratory professionals, nurses, informatics specialists, infection preventionists, performance improvement staff, or others.
Putting in work to establish, strengthen, and preserve relationships is time well spent for antimicrobial stewards. As you do this I have found that being genuine and truthful is key. Additionally acknowledging your limitations and being willing to admit that you do not know it all is equally important. People respect other people who work hard independently but are still willing to ask for help. It’s not about impressing people, it’s about mutual respect and trust.
2. Let the Data Guide Your Work
Trying to explain an opinion, perspective, or anecdote to someone might work sometimes, but data rules when it comes to influencing change. Antimicrobial stewardship champions should seek to obtain existing data and develop methods for obtaining new data. Many people in healthcare are very intelligent and highly educated. Do not try to educate them on what needs to happen. Show them the data and let them come to the same conclusions. Heck, they may even offer better solutions to the problems than what you were thinking!
3. Pick your Battles. Do Not Sacrifice the War to Win a Battle.
This is a daily struggle for many clinical pharmacists and antimicrobial stewardship pharmacists are no exception. It really ties back to the first item on the list, but this is so important it deserves a place of its own. Building, expanding, and maintain an antimicrobial stewardship program is like running a marathon. You need to look at your plans over years or even decades. In doing this, be very careful about which battles you are willing to push the envelope on. You may find the satisfaction of having it your way now can later lead to stifled progress for your program in other areas later.
4. Anticipate that Every Institution has Unique Needs
People want life to be easy. If something worked for one institution, why can’t we just do that too? This unfortunately is often not the case with antimicrobial stewardship. As antimicrobial stewards, we need to learn to live with this fact and use our awareness to position ourselves for success.
The physical spaces, patient populations served, hours of operation, practice setting, specialty services offered, organizational culture, prescribing practices, departmental workflows, medical technology, and staff makeup are just a few items which can drastically impact the needs of an institution. Going back again to the first item on this list, it is those relationships that you develop with your colleagues that will enable an awareness of needs, which will in turn allow you to develop functional antimicrobial stewardship program action plans.
5. Listen to Others and Do Not Go it Alone
Antimicrobial stewardship is a team sport. When the healthcare team wins, the patients win too.
Once again we come back to the first point. Leveraging relationships to bring stakeholders together is how successful projects are born and eventually executed. The field of antimicrobial stewardship is too complex for anyone to tackle it all on their own. Start with the mindset that you will need to work with an interprofessional group to achieve your program goals.
Remember too that being a good team player is not just about bringing people together, it is also about listening to others and using their guidance to steer initiatives in the right direction.
Managing an antimicrobial stewardship program can be very complicated and pose a myriad of challenges. It is important that we learn from each other and use those lessons learned to guide our paths. I hope you have found this interesting and wish you well on your journey!
Disclaimer: The views and opinions expressed in this article are that of the author and do not necearilly reflect those of any past, current, or potential future employer.
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