title: Use of computer decision support in an antimicrobial stewardship program (ASP).
abstract: OBJECTIVE
  Document information needs, gaps within the current electronic applications and reports, and workflow interruptions requiring manual information searches that decreased the ability of our antimicrobial stewardship program (ASP) at Intermountain Healthcare (IH) to prospectively audit and provide feedback to clinicians to improve antimicrobial use.
  
  
  METHODS
  A framework was used to provide access to patient information contained in the electronic medical record, the enterprise-wide data warehouse, the data-driven alert file and the enterprise-wide encounter file to generate alerts and reports via pagers, emails and through the Centers for Diseases and Control's National Healthcare Surveillance Network.
  
  
  RESULTS
  Four new applications were developed and used by ASPs at Intermountain Medical Center (IMC) and Primary Children's Hospital (PCH) based on the design and input from the pharmacists and infectious diseases physicians and the new Center for Diseases Control and Prevention/National Healthcare Safety Network (NHSN) antibiotic utilization specifications. Data from IMC and PCH now show a general decrease in the use of drugs initially targeted by the ASP at both facilities.
  
  
  CONCLUSIONS
  To be effective, ASPs need an enormous amount of "timely" information. Members of the ASP at IH report these new applications help them improve antibiotic use by allowing efficient, timely review and effective prioritization of patients receiving antimicrobials in order to optimize patient care.
authors.affiliation: Medical Informatics, Intermountain Healthcare, University of Utah , Salt Lake City, Utah ; Biomedical Informatics, University of Utah, University of Utah , Salt Lake City, Utah.
authors.forename: R S
authors.initials: RS
authors.lastname: Evans
authors.affiliation: Pharmacy, Primary Children's Medical Center, University of Utah , Salt Lake City, Utah.
authors.forename: J A
authors.initials: JA
authors.lastname: Olson
authors.affiliation: Clinical Epidemiology and Infectious Diseases, Intermountain Medical Center, University of Utah , Salt Lake City, Utah.
authors.forename: E
authors.initials: E
authors.lastname: Stenehjem
authors.affiliation: Pharmacy, Intermountain Medical Center, University of Utah , Salt Lake City, Utah.
authors.forename: W R
authors.initials: WR
authors.lastname: Buckel
authors.affiliation: Pediatric Infectious Diseases, University of Utah , Salt Lake City, Utah.
authors.forename: E A
authors.initials: EA
authors.lastname: Thorell
authors.affiliation: Medical Informatics, Intermountain Healthcare, University of Utah , Salt Lake City, Utah.
authors.forename: S
authors.initials: S
authors.lastname: Howe
authors.affiliation: Medical Informatics, Intermountain Healthcare, University of Utah , Salt Lake City, Utah.
authors.forename: X
authors.initials: X
authors.lastname: Wu
authors.affiliation: Clinical Epidemiology and Infectious Diseases, Intermountain Medical Center, University of Utah , Salt Lake City, Utah.
authors.forename: P S
authors.initials: PS
authors.lastname: Jones
authors.affiliation: Medical Informatics, Intermountain Healthcare, University of Utah , Salt Lake City, Utah.
authors.forename: J F
authors.initials: JF
authors.lastname: Lloyd
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D054869:Clinical Audit; D016638:Critical Illness; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D034742:Electronic Mail / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D013223:Statistics as Topic
chemical_list: D000900:Anti-Bacterial Agents
keywords: ASP; Clinical decision support; antibiotic resistance; antimicrobial stewardship; antimicrobial stewardship program; computer decision support; medical informatics; patient specific alerts
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