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The Ascension Experience: Building the Infrastructure for Antimicrobial Stewardship in a Large Health System

Posted on by CDC's Safe Healthcare Blog

Roy Guharoy, Pharm.D., MBA
Roy Guharoy, Pharm.D., MBA
You might have heard of Ascension – after all, it’s the largest nonprofit health system in the United States. We have 141 hospitals and more than 21,000 acute care beds in 25 states and the District of Columbia.

But what you may not have heard is we have made swift progress in our antimicrobial stewardship. Here are four key principles we’ve incorporated into our overall objectives to reduce antibiotic-related adverse events (such as Clostridium difficile (C. Difficile) infections) and improve appropriate antibiotic use:

  • Making antibiotic stewardship a system priority with full leadership support.
  • Creating an infrastructure to promote and share best practices.
  • Promoting the careful use of narrow-spectrum antibiotics, or antibiotics that are specifically effective against a limited number of bacteria.
  • Helping hospitals achieve their goals.

We’re constantly engaging our people and refining our processes as we work to improve antibiotic stewardship and decrease the spread of resistance. Every one of our hospitals has a physician/pharmacist duo who works together to implement antimicrobial monitoring, promote compliance with the national recommendations, and evaluate and implement other initiatives based on local needs.

Knowing there’s strength in numbers, we’ve also assembled committees to manage specific stewardship-related efforts. The Ascension Health Antimicrobial Stewardship (AHAS) Committee is comprised of 30+ infectious diseases physicians and pharmacists and establishes indications for antimicrobial use, appropriate testing and disease-specific therapies. Our Center of Excellence (COE) for Antimicrobial Stewardship and Infection Prevention oversees all efforts related to antimicrobial stewardship and coordinates local, regional, and national activities.

When it comes to processes, we’ve invested in clinical decision support systems to help system healthcare providers evaluate patients’ antibiotic use and get real-time insight they can use to develop the best care plan for each patient. We work with our providers to strengthen their antibiotic stewardship expertise, and we’re committed to the ongoing tracking and evaluation of antibiotic use data.

We are proud of our results. Ascension saw reductions in antibiotic use and a 15.9% reduction in C. difficile infections. One 376-bed teaching hospital drove a 70 percent drop in the use of selected antibiotics over a six-month period. Learn more about our commitment to antibiotic stewardship, or visit https://www.cdc.gov/getsmart/healthcare for information and resources to help you implement or improve antibiotic use in your facility.

Roy Guharoy, Pharm.D., MBA is the Vice President of Clinical Integration for Ascension Health.

Posted on by CDC's Safe Healthcare Blog

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