1867. A Regional Collaboration to Share Antimicrobial Stewardship Resources in Three Geographically Related Veterans Affairs Medical Centers

Abstract

BackgroundAntibiotic Stewardship (AS) programs are tasked with monitoring the use of antimicrobial agents across a variety of clinical settings. Most medical centers work independently, developing their own programs and using various clinical surveillance systems (CSSs) to identify intervention opportunities and monitor metrics. Geographically related medical centers may share patients and similar environments, and could benefit from working collaboratively to share knowledge and resources.MethodsThe AS programs were assessed at three Veterans Affairs Medical Centers (VAMCs) in three neighboring states (DC, MD, and WV) over 2016 and 2017. The AS programs cover 350 acute care beds and 422 long-term care (LTC)/rehab beds. Each AS team has one infectious disease physician and one pharmacist. A SharePoint site was developed; meetings and teleconferences were held regularly. By way of a shared contract, a CSS (Theradoc, DSS Inc.) was installed at all three VAMCs between November 2015 and March 2016. Within TheraDoc, each AS program designed alerts and interventions specific to its own medical center and collaborated to develop a group of 22 interventions that were shared by all sites. There was no attempt to alter individually determined AS practices of each VAMC.ResultsThe table demonstrates the combined AS team interventions and aggregate cost-saving generated by the shared CSS. The number of interventions and the hours spent in CSS varied between centers; the top five most heavily conducted interventions differed between sites. Over time, new interventions developed at one VAMC were adopted at one or more of the other VAMCs at the discretion of the respective AS teams. Within a short period of time the cost savings generated exceeded the CSS start-up investment.CY 2016CY 2017CombinedAS interventions2,94610,01612,962Time spent AS PharmDs (hours)4722,0322,503Time spent AS MD (hours)199308508Cost savings$532,520$1,790,906$2,323,426ConclusionWorking collaboratively allowed each VAMC to leverage shared resources. Each AS program was able to adapt to its VAMC’s specific needs, while also demonstrating significant aggregate cost savings as a result of coordinated and defined AS activities.Disclosures M. Zuzick, Document Storage Systems: Employee, Salary. J. Chang, Document Storage Systems: Employee, Salary.