1824. Care Transformation in Infectious Diseases: Using a Novel Approach for Tracking Antimicrobial Stewardship Metrics

Abstract

BackgroundA key component of antimicrobial stewardship (AS) programs is the use of adequate metrics to monitor antimicrobial utilization. Limitations have been described in the literature for traditional metrics such as Defined Daily Doses (DDD) and Days of Therapy (DOT), including practitioner’s unfamiliarity with the terminology in relation to their meaning. This abstract describes an innovative approach developed by our organization that resulted in improved utilization of high-cost antimicrobials and increased the engagement of practitioners based on real-time (RT) analytics using a novel metric: Defined Daily Goal (DDG).MethodsA RT medication utilization dashboard (DB) for daptomycin (DAP) was created in October 2017 by clinical analysts and pharmacists. The DB provides a list of patients with active orders for DAP and compares the sum of active orders to the sum of available orders to meet the DDG. At Florida Hospital Orlando (FHO), the DAP goal based on national benchmark data were 6.8 days of therapy (DOT)/1,000 patient days (PDs) or a total of 240 orders/month. The average PDs/month was calculated to be 35, 380, thus the DAP DDG for FHO was determined to be 8 orders/day to meet a goal of 6.8 DOT/month. This goal of 8 DAP orders/day was built into the DB for daily AS team review. This calculation allowed for a conversion of our monthly DOT goal to a DDG equivalent.ResultsFrom October to December 2017, the DB identified an average of 230.7 orders/month at FHO, which was below the goal of 240 orders/month. Visualizing the daily goals for the number of allotted orders for DAP using a DDG format, this allowed the AS team to effectively meet the DOT/1,000 PDs goal. Focusing on the DDG combined with standard AS activities, resulted in a significant reduction of DAP utilization. When discussing utilization goals with ID specialists and general practitioners, the use of the DDG concept proved to be intuitive and facilitated understanding around specific metrics.ConclusionImplementation of a medication utilization RT DB, combined with the introduction of the DDG concept, allowed for an actionable measure to trend daily and facilitated the goals of our AS program. Based on this valuable information provided by the DB, this intiative has now been expanded to include other high-cost agents across all campuses.Disclosures All authors: No reported disclosures.