title: Establishing an antimicrobial stewardship program.
abstract: Hospitals are faced with increasing challenges of antibiotic-resistant organisms and rising antimicrobial costs despite widespread attention to infection prevention and control measures. Government, professional organizations and accreditation bodies are all signalling an urgent need for the establishment of programs in hospitals to address antibiotic misuse. Although variations of such "antimicrobial stewardship programs" have been functioning in Canada for some time, a formal approach using change management and quality improvement principles has largely been lacking. We describe how we have established such a program in a teaching hospital, modelled on John Kotter's eight steps of leading change.
authors.affiliation: Antimicrobial Stewardship Program, Mount Sinai Hospital and University Health Network, and Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario. amorris@mtsinai.on.ca
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Morris
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Stewart
authors.forename: Maureen
authors.initials: M
authors.lastname: Shandling
authors.forename: Scott
authors.initials: S
authors.lastname: McIntaggart
authors.forename: W Conrad
authors.initials: WC
authors.lastname: Liles
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D002170:Canada; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000592:standards; D006801:Humans; D017053:Infection Control / Q000458:organization & administration; D011785:Quality Assurance, Health Care
chemical_list: D000900:Anti-Bacterial Agents