HMS Antimicrobial Use Toolkit

Establish a multidisciplinary workgroup within the antimicrobial stewardship team to lead quality improvement efforts for UTI and pneumonia antibiotic use, with a designated lead to oversee implementation, stakeholder engagement, and data-driven intervention strategies. The group should meet quarterly, communicate with leadership, apply behavioral insights to interventions, and implement at least two new initiatives annually, adjusting based on outcome assessments.

Develop and disseminate institutional guidelines for CAP and UTI/ASB that align with national and HMS recommendations—emphasizing appropriate antibiotic use, treatment duration, and transitions to oral therapy—while promoting provider engagement and sharing data to drive improvement.

Implement a comprehensive, multidisciplinary strategy to educate healthcare providers and patients about antibiotic resistance and appropriate prescribing, using data-driven feedback, system-level integration, and tailored communication to support behavior change and improve adherence to institutional guidelines. Engage frontline staff through inclusive development, continuous feedback, and clinical decision support tools to enhance quality and outcomes.

Educate providers on updated CAP guidelines, emphasizing shorter therapy durations and the elimination of HCAP, while tailoring interventions by provider type and focusing on discharge prescribing, where most inappropriate antibiotic use occurs. Implement system-level changes such as improved documentation, order set alignment, audit and feedback, and performance incentives to support appropriate antibiotic use for uncomplicated CAP.

Educate providers and patients on differentiating ASB from UTI to reduce unnecessary antibiotic use, using targeted interventions, data review, and diagnostic stewardship strategies. Implement system-level changes such as documentation requirements, decision support tools, revised order sets, and audit/feedback mechanisms to discourage inappropriate testing and treatment, especially in asymptomatic cases.

Optimize antibiotic use by narrowing empiric therapy for CAP and UTI, promoting safer alternatives to fluoroquinolones, and enhancing documentation and stewardship practices such as antibiotic timeouts and pharmacist involvement. Specifically for pneumonia, the focus is on de-escalating unnecessary MRSA and Pseudomonas coverage using culture data, while UTI recommendations include improving interpretation of lab results to avoid treating likely contaminants.

Improve the diagnosis and management of community-acquired pneumonia (CAP) versus questionable pneumonia (QPNA) through provider and patient education, targeted feedback, and diagnostic stewardship. Key strategies include enhancing documentation, auditing QPNA treatment patterns, and tailoring interventions to specific provider groups with leadership support from designated champions.