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Bohn BC, Neuner EA, Athans V, et al. The Implementation and Effect of Weekend Pharmacy-Driven Antimicrobial Stewardship Services at a Large Academic Medical Center. J Pharm Pract. 2021;897190021997008doi: 10.1177/0897190021997008.
Bohn, B. C., Neuner, E. A., Athans, V., Rivard, K. R., Riffle, A. R., Richter, S. S., Fraser, T. G., & Gordon, S. M. (2021). The Implementation and Effect of Weekend Pharmacy-Driven Antimicrobial Stewardship Services at a Large Academic Medical Center. Journal of pharmacy practice, 897190021997008. https://doi.org/10.1177/0897190021997008
Bohn, Brian C, et al. "The Implementation and Effect of Weekend Pharmacy-Driven Antimicrobial Stewardship Services at a Large Academic Medical Center." Journal of pharmacy practice vol. (2021): 897190021997008. doi: https://doi.org/10.1177/0897190021997008
Bohn BC, Neuner EA, Athans V, Rivard KR, Riffle AR, Richter SS, Fraser TG, Gordon SM. The Implementation and Effect of Weekend Pharmacy-Driven Antimicrobial Stewardship Services at a Large Academic Medical Center. J Pharm Pract. 2021 Mar 02;897190021997008. doi: 10.1177/0897190021997008. Epub 2021 Mar 02. PMID: 33648376.
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J Pharm Pract. 2021 Mar 02;897190021997008. doi: 10.1177/0897190021997008. Epub 2021 Mar 02.

The Implementation and Effect of Weekend Pharmacy-Driven Antimicrobial Stewardship Services at a Large Academic Medical Center.

Journal of pharmacy practice

Brian C Bohn, Elizabeth A Neuner, Vasilios Athans, Kaitlyn R Rivard, Allison R Riffle, Sandra S Richter, Thomas G Fraser, Steven M Gordon

Affiliations

  1. Department of Pharmacy, Norton Healthcare, Louisville, KY, USA.
  2. Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, MO, USA.
  3. Department of Pharmacy, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
  4. Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA.
  5. Global Medical Affairs, bioMérieux, Durham, NC, USA.
  6. Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH, USA.

PMID: 33648376 DOI: 10.1177/0897190021997008

Abstract

BACKGROUND: In September 2018, pharmacy antimicrobial stewardship (AMS) services were expanded to include weekends at this academic medical center. Activities performed by AMS pharmacists on the weekends include blood culture rapid diagnostic (RDT) review, antiretroviral therapy (ART) review, prospective audit and feedback (PAF) utilizing clinical decision support, vancomycin dosing, and operational support. The purpose of this study was to assess the operational and clinical impact of these expanded AMS services.

METHODS: This single-center, quasi-experimental study included data from weekends before (9/2017-11/2017) and after (9/2018-11/2018) implementation. The descriptive primary outcome was the number of activities completed for each AMS activity type in the post-implementation group only. Secondary outcomes were time to AMS opportunity resolution, time to escalation or de-escalation following PAF or RDT alert, time to resolution of miscellaneous AMS related opportunities, length of stay (LOS), and antimicrobial use outcomes.

RESULTS: During the post-implementation period 1258 activities were completed, averaging 97/weekend. Inclusion criteria for time to resolution outcomes were met by 72 patients pre-implementation and 59 patients post. The median (IQR) time to AMS opportunity resolution decreased from 18.5 hours pre-intervention (7.7-35.7) to 8.5 hours post-intervention (IQR 1.8-14.0), p < 0.01. Time to escalation was 11.6 hours compared to 1.7 hours (p = 0.1), de-escalation 16.7 hours compared to 10.8 hours (p = 0.03), and miscellaneous opportunity 40.8 hours compared to 13.2 hours (p = 0.01). No differences were observed in LOS or antimicrobial use outcomes.

CONCLUSION: Presence of pharmacist-driven weekend AMS services significantly reduced time to resolution of AMS opportunities. These data support the value of weekend AMS services.

Keywords: antimicrobial stewardship; infectious diseases; pharmacy; weekend

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