RESEARCH ARTICLE
Impact of a Prospective Audit and Feedback Antimicrobial Stewardship Program at a Veterans Affairs Medical Center: A Six-Point Assessment Haley J. Morrill1,2,3, Aisling R. Caffrey1,2,3, Melissa M. Gaitanis1,4, Kerry L. LaPlante1,2,3,4* 1 Veterans Affairs Medical Center, Infectious Diseases Research Program, Providence, Rhode Island, United States of America, 2 University of Rhode Island, Department of Pharmacy Practice, College of Pharmacy, Kingston, Rhode Island, United States of America, 3 Veterans Affairs Medical Center, Center of Innovation in Long Term Services and Supports, Providence, Rhode Island, United States of America, 4 Warren Alpert Medical School of Brown University, Division of Infectious Diseases, Providence, Rhode Island, United States of America *
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OPEN ACCESS Citation: Morrill HJ, Caffrey AR, Gaitanis MM, LaPlante KL (2016) Impact of a Prospective Audit and Feedback Antimicrobial Stewardship Program at a Veterans Affairs Medical Center: A Six-Point Assessment. PLoS ONE 11(3): e0150795. doi:10.1371/journal.pone.0150795 Editor: John Conly, University of Calgary, CANADA
Abstract Background Prospective audit and feedback is a core antimicrobial stewardship program (ASP) strategy; however its impact is difficult to measure.
Received: August 11, 2015 Accepted: February 19, 2016
Methods
Published: March 15, 2016
Our quasi-experimental study measured the effect of an ASP on clinical outcomes, antimicrobial use, resistance, costs, patient safety (adverse drug events [ADE] and Clostridium difficile infection [CDI]), and process metrics pre- (9/10–10/11) and post-ASP (9/12–10/13) using propensity adjusted and matched Cox proportional-hazards regression models and interrupted time series (ITS) methods.
Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: These authors have no support or funding to report. This material is based upon work supported, in part, by the Office of Research and Development, Department of Veterans Affairs. Competing Interests: Haley J. Morrill is supported by an Office of Academic Affiliations fellowship, the Providence VAMC Center of Innovation (COIN) in Long-Term Services and Supports for Vulnerable Veterans, and a VA New England Healthcare System Early Career Development Award. Aisling R. Caffrey
Results Among our 2,696 patients, median length of stay was 1 day shorter post-ASP (5, interquartile range [IQR] 3–8 vs. 4, IQR 2–7 days, p
