Author – Dr. Trivedi,
California Antimicrobial Stewardship Program Initiative,
California Department of Public Health.
In February 2010, the California Department of Public Health (CDPH) launched the country’s first statewide initiative to promote optimization of antimicrobials in healthcare facilities. In less than two years, the cutting-edge California Antimicrobial Stewardship Program (ASP) Initiative is helping California healthcare facilities establish programs to improve patient safety and quality.
The Healthcare Associated Infections (HAI) Program of CDPH developed the statewide California Antimicrobial Stewardship Program (ASP) Initiative as the result of a statutory mandate. California Senate Bill 739 required CDPH to ensure that each general acute care hospital assemble a quality improvement committee to oversee the results of a process for evaluating the judicious use of antibiotics. While hospitals were aware of this mandate, they were left to implement programs on their own. The Initiative offers California healthcare facilities a valuable resource for antimicrobial use education, guidance and consultation.
Current program activities include assessing ASPs in California healthcare facilities, assessing antimicrobial susceptibility patterns throughout California hospitals, providing consultative advice and practical evidence for administrative buy-in, developing regional collaborations, and a focus on special settings such as long-term acute care hospitals and long-term care facilities. The Initiative is developing statewide recommendations for internal and external benchmarking measures for ASPs. Finally, the Initiative is participating in drafting regulations to implement legislation and specify characteristics of ASPs required in California acute care hospitals.
The California ASP Initiative embodies the core functions of public health. The Initiative monitors, detects and investigates antimicrobial resistance and antimicrobial utilization, educates clinicians and administrators to adopt ASPs, partners with healthcare facilities and identifies best ASP strategies and practices to share across healthcare systems. The Initiative also interprets laws and regulations to improve public health and patient safety, strives to ensure a minimum performance standard of hospital-based ASPs, evaluates and improves current ASPs, and is researching innovative solutions such as strategies in resource-limited settings.
Given the progress of the California ASP Initiative in such a short period of time, other states should consider establishing statewide resources for antimicrobial use, education, guidance and consultation to assist US healthcare facilities in establishing these patient safety and quality improvement programs.