1052. Antimicrobial Stewardship: On Board with Lean Daily Management System

Abstract

BackgroundLimited guidance exists on how to design and measure the efficiency and effectiveness of an antimicrobial stewardship program (ASP). Our established ASP sought to broaden interprofessional accountability and enhance our programmatic efficiency by employing Lean Daily Management System (DMS) procedures.MethodsTo improve ASP communication, a visual and systematic approach to identify, address, and resolve ASP projects while quantifying nontraditional metrics measuring the efficiency and effectiveness was developed. Through shared discussions, an interdisciplinary group of stakeholders produced the following deliverables: (a) established shared programming goals/metrics; (b) improved prioritization methods and project tracking through completion; (c) developed readiness and metric boards to display achievements, current activity, and metrics; (d) identified programming threats and strategies to strengthen our provided services.ResultsAt 6 months following DMS adoption, our ASP has disbanded monthly meetings in lieu of weekly, 15 minute huddles utilizing the readiness and metric boards. We achieved consistent and interprofessional representation where each member is accountable for leading huddles, providing reports, and owning projects. Using a stoplight color system to indicate status, potential ASP influencers are tracked and reported: clinical workload/demands, organizational awareness, equipment/supplies, staffing, project updates, and announcements. The visual identification allows the team to address “quick hits” or escalate resource allocation to solve “big issues” (figure). Program metrics are codified under the domains of delivery, people, quality, safety, and financial stewardship. Administrative leadership has attended huddles and provided positive and constructive feedback to foster a process of continuous improvement.ConclusionIntegration of Lean DMS huddles provides a collaborative, interactive and interdisciplinary approach to enhance shared awareness and to broaden the reach and efficiency of our ASP. With project tracking mechanisms in place, our team is refining our problem-solving abilities to ensure a congruent plan between issues raised and established program metrics. Disclosures All authors: No reported disclosures.