Approaches to Modifying the Behavior of Clinicians Who Are Noncompliant With Antimicrobial Stewardship Program Guidelines.
Antimicrobial stewardship programs (ASPs) are a key national initiative to promote appropriate use of antibiotics and to reduce the burden of resistance. The dilemma of managing the outlier physician is especially complex. We outline strategies to establish a successful ASP that reviews appropriate efforts to achieve the goal of modifying outlier physicians' behavior. One must try to differentiate deviation from ASP norms from all other issues of outliers. Essential elements include identifying and understanding the local problems, planning, and achieving hospital administration and medical staff support. A successful ASP includes effective communication and acceptance of evidence-based recommendations, so that patient clinical outcomes will be optimized.
R. M. Alden Research Laboratory, Santa Monica David Geffen School of Medicine at UCLA, Los Angeles, California.
Ellie J C
EJ
Goldstein
Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus.
Debra A
DA
Goff
Pharmacy Department, Kindred Hospital Los Angeles.
William
W
Reeve
Pharmacy Department, Providence St John's Health Center, Santa Monica.
Snezana
S
Naumovski
California Department of Public Health, Healthcare-Associated Infections Program.
Erin
E
Epson
Infectious Diseases Division, John Hopkins University School of Medicine, Baltimore, Maryland.
Jonathan
J
Zenilman
Wayne State University and Detroit Medical Center, Michigan.
Keith S
KS
Kaye
Summa Health System and Northeast Ohio Medical University, Akron.
Thomas M
TM
File
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000073602:Antimicrobial Stewardship; D003142:Communication; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006801:Humans; D010820:Physicians; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'
D000900:Anti-Bacterial Agents
ASP; antibiotic stewardship; outlier physicians; peer review