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Weir C, Butler J, Sutton JD, Graber CJ, Goetz MB, Madaras-Kelly KJ, Jones M, Samore M, Glassman PA. The experience of stewards in using a visual analytic tool to benchmark and track therapy duration for pneumonia, urinary tract infections, and skin and soft tissue infections. [Abstract]. Open forum infectious diseases. 2017 Oct 4; 4(Supplemental 1):S279-S280.
Background Antibiotic stewardship programs (ASP) engage in many diverse activities, ranging from education, individual consultation and quality improvement programs to restrict antibiotic use. All of these activities need high quality antimicrobial use (AU) data. However, current available data sources do not provide the indication for use or AU data at key decision points. Methods We developed a visual analytic interactive tool that characterizes patient-level AU on days 0-2 (Choice), 3-4 (Change) and 5-6 (Completion) of therapy (CCC) for pneumonia, skin-soft-tissue infections and urinary tract infection. Development of the tool involved months of iterative participant design work involving the stewards from 8 VA hospitals. To understand their information needs, we conducted 10 semi-structured interviews targeted at their experience using the tool. Interviews focused on 3 main areas: 1) the overall activities of each ASP; 2) a description of a specific experience using the; and 3) their perceived efficacy and knowledge regarding choice, change and completion, and 4) perceptions of usefulness and usability. Twelve ASP team members were interviewed from 8 VA sites. Results The research team identified 6 emergent themes: 1) Having real data provides more solid ground and security for evidence-based practice. 2) Using the data is different than having the data 3) Trust in the quality of data is not given and requires interaction, validation, and individual work. 4) The tool is more than support for individual decision-making - it is a communication tool for creating a sense of shared awareness within the institution. 5) Data motivates: We have the support to engage actively in continuous improvement and self-evaluation. 6) Matching the tool to our needs is not easy and is a process of calibration and mutual transformation. Conclusion Implementing a visual analytic tool to support ASP activities is more than education. It involves an iterative process of mutual discovery and development. Stewards varied in how they used the tool and what information was useful. The main focus was on information that is individually relevant to the institution, information that matches local ASP activities, and data reports that can serve as communication tools. Disclosures All authors: No reported disclosures.
