Poster: Implementation and Rapid Uptake of an Antimicrobial Stewardship Clinical Decision Support System Across 19 UPMC Hospitals - Infectious Disease Connect Poster: Implementation and Rapid Uptake of an Antimicrobial Stewardship Clinical Decision Support System Across 19 UPMC Hospitals - Infectious Disease Connect

Academic Literature

Poster: Implementation and Rapid Uptake of an Antimicrobial Stewardship Clinical Decision Support System Across 19 UPMC Hospitals

This poster highlighting antimicrobial stewardship clinical decision support system implementation was originally presented at IDWeek 2022, held Oct. 19-23 in Washington, D.C.

Ryan Bariola, M.D.1,2; Tina Khadem, PharmD1,2; Caley Yakemowicz2; Courtney Simonick2;
Erin McCreary, PharmD1,2; Christina Andrzejewski; John W. Mellors. M.D.1,2; Rima C. Abdel-Massih, M.D.1,2
Contact: bariolajr@upmc.edu

1. Division of Infectious Diseases, UPMC 2. Infectious Disease Connect, Pittsburgh, PA USA

Conclusions

  • Having implemented a clinical decision support system (CDSS) for antimicrobial stewardship (AMS) across 19 hospitals in five months, the successful adoption and use of the software was demonstrated by increased monthly CDSS utilization and a high intervention acceptance rate.
  • Communication within the software was frequent and increased over time. Despite a high rate of nonactionable alerts seen in the first six months of use, ILÚM Insight was frequently and consistently used in this multisite model.
  • The CDSS facilitated high intervention rates and streamlined documentation at those hospitals without local ID expertise.

Background

Methods

Table 1

Category 1

  • Beta-lactam allergy evaluation
  • Duplicate anaerobic coverage
  • IV to PO
  • Active IV vancomycin with negative MRSA nasal screen
  • Positive C. difficile

Category 2

  • Antimicrobial timeout (48h, 72h or 96h)
  • Broad spectrum beta-lactam agents
  • Restricted antimicrobial
  • Antipseudomonal agent without Pseudomonas in culture at 96 hours
  • Bug-drug mismatch (all sources)
  • De-escelation Susceptibility
  • Positive blood culture
  • Positive Cerebrospinal Fluid culture

Results

Table 2
Final Alert StatusMonthly Average (N)Average Monthly Total Reviewed Alerts (N)% of Total Reviewed Alerts% of Actionable Alerts
Successful
– Intervention Accepted
959703314%93%
Failures
– Intervention Rejected
7070331%7%
Already Appropriate
– Current therapy ok
– No treatment needed
1795703326%N/A
Nonactionable alerts
– Duplicate alert
– Discharged prior to intervention
2694703338%N/A

Disclosures

Rima Abdel-Massih is Co-founder, CMO, and share option holder of Infectious Disease Connect. John Mellors is Co-founder, Advisory Board Chair, and share option holder of Infectious Disease Connect. All other contributing authors have no disclosures.


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