GOP Information | |
Organisation sharing the GOP |
Related practices from PaSQ database
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Directorade of Quality, Research, Development and Innovation Andalusian Regional Ministry of Health and Social Welfare |
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Topic | |
Quality improvement project |
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Category | |
Infection control / Prevention of surgical site infections Assessment of risk and harm |
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GOP Description | |
Implementation level | |
Regional | |
Clinical settings | |
Andalusian Public Health System Hospitals | |
Objectives | |
1. Optimize the use of antimicrobials in the hospital. 2. Reduce mortality of patients with severe infections. 3. Reduce morbidity of patients with severe infections. 4. Reducing bacterial resistance. 5. Reduce economic costs. |
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Population | |
program directed towards all antibiotic prescribers of Andalusian Public Health System | |
Methods | |
Methodology | |
Design and implementation: Step 1: Institutional agreements Step 2: Constitution of a multidisciplinary operations team Step 3: Elaboration of local guidelines Step 4: PRIOAM implementation Step 5: The main activity of the program consists on a training program directed towards all antibiotic prescribers of the center based on counselling interviews Step 6: Improvement of antimicrobial prescription. |
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Timeframe implementation | |
The program began in January 2011, implementation in 3 years | |
Implementation tools available | |
Guidelines, training program, PRIOAM advvisors | |
Implementation cost | |
Staff required: 1 post-doctoral researcher …………………… 27.000 € 2-years contract as a part-time job. – Office supplies (including 1 personal computer) ……….…. 900 € – Dissemination of the results ……………………………………… 3.700 € One international congress and one national congress, travel costs included.TOTAL: 31.600 € |
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Results | |
Method used to measure the results | |
The main activity of the program consists of a training program directed towards all antibiotic prescribers of the centre based on counselling interviews (CI) which will be held by experts on infectious diseases from the centre face-to-face with antibiotic prescribers.
1st year end-points: Improvement of antimicrobial prescription and reduction in antibiotic consumption. 2nd year end-points: clinical and ecological impact of the program. |
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Results | |
1006000€ saved in a year in the pilot Hospital | |
Analysis of the results | |
Our results demonstrate significant benefits of PRIOAM, an institutional, education-based ASP 12 months after its implementation. The rate of appropriate treatments was improved by 30%, whilst antimicrobial consumption was decreased by 26% and acceptance among clinicians of the centre was excellent.
These data have proven that an educational program with an institutional basis can be as effective as direct-control interventions. The rate of appropriate treatments by the end of the first year was superior to 75%, results that are similar to those published for other audit-based programs. Our program also achieved an important decrease in all-class antimicrobial consumption by 26%. At the end of 2011, this consumption was recorded to be 874.2 DDD/1000 bed-days. This rate of consumption places our hospital near the average of other tertiary Spanish hospitals in 2009, reported to be 864 DDD. This result is in favour of our center, considering our noticeably higher number of ICU beds (90 beds vs. a mean of 28 ICU beds in other centers) and the especially active transplantation program. This reduction has not been achieved through restrictive measures targeted towards specific antibiotics, but through the training of clinicians in the sensitive use of antimicrobials. Its pedagogic approach has been the key to the program’s success and its excellent level of acceptance among interviewed clinicians. Finally, there are novel elements incorporated by this program ensuring its sustainability, e.g. its transversal design, the involvementof clinicians from all departments, the low extra-burden of work required to implicate the proposed pedagogic methodology in daily clinical practice, and the strong institutional support, which has linked the program consecution to economic incentives. |
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Implementation barriers | |
Did you find implementation barriers? | |
No | |
Please describe implementation barriers | |
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Describe the strategies used to overcome the barriers (If needed) | |
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Other information | |
Other information about the GOP that you would like to add (Link or attached document) | |
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Contact information | |
Name: Jerónimo Pachón Díaz Position/function: Quality, Research, Development and Innovation General Director Department: Directorate of Quality, Research, Development and Innovation Organisation: Andalusian Regional Ministry of Health and Social Welfare City: Seville Country: Spain Region: Andalusia |