Antimicrobial stewardship and quality improvement strategies in critical access hospitals: a process evaluation of an intensive quality improvement cohort

Zahra Kassamali-Escobar; Whitney Hartlage; Jeannie D Chan; Alyssa Castillo; Natalia Martinez-Paz; Maria Bajenov; Rupali Jain; John B Lynch; Chloe Bryson-Cahn

doi:10.1017/ash.2024.458

Antimicrobial stewardship and quality improvement strategies in critical access hospitals: a process evaluation of an intensive quality improvement cohort

Antimicrob Steward Healthc Epidemiol. 2024 Nov 11;4(1):e201. doi: 10.1017/ash.2024.458. eCollection 2024.

Authors

Zahra Kassamali-Escobar^{1

2

3}, Whitney Hartlage^{1

4}, Jeannie D Chan^{1

2

5}, Alyssa Castillo^{1

6}, Natalia Martinez-Paz^{1

7}, Maria Bajenov^{1

7}, Rupali Jain^{1

2

5}, John B Lynch^{1

5

7}, Chloe Bryson-Cahn^{1

5}

Affiliations

¹ Center for Stewardship in Medicine, University of Washington School of Medicine, Seattle, WA, USA.
² School of Pharmacy, University of Washington, Seattle, WA, USA.
³ Fred Hutchinson Cancer Center, Seattle, WA, USA.
⁴ Veteran's Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA.
⁵ Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
⁶ Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
⁷ International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, WA, USA.

Abstract

We describe our experience implementing an intensive quality improvement cohort pilot focused on managing asymptomatic bacteriuria in 19 critical access hospitals. Participation in the pilot was high, and almost all sites identified an improvement goal and collected clinical data. Barriers to implementation included staffing shortages, turnover, and lack of bandwidth.