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1052. Antimicrobial Stewardship: On Board with Lean Daily Management System
BACKGROUND: Limited guidance exists on how to design and measure the efficiency and effectiveness of an antimicrobial stewardship program (ASP). Our established ASP sought to broaden interprofessional accountability and enhance our programmatic efficiency by employing Lean Daily Management System (D...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811027/ http://dx.doi.org/10.1093/ofid/ofz360.916 |
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author | Monsees, Elizabeth Monsees, Elizabeth Wirtz, Ann Myers, Angela Myers, Angela Burns, Alaina Day, Chris El Feghaly, Rana E Lee, Brian R Purandare, Amol Weddle, Gina Goldman, Jennifer |
author_facet | Monsees, Elizabeth Monsees, Elizabeth Wirtz, Ann Myers, Angela Myers, Angela Burns, Alaina Day, Chris El Feghaly, Rana E Lee, Brian R Purandare, Amol Weddle, Gina Goldman, Jennifer |
author_sort | Monsees, Elizabeth |
collection | PubMed |
description | BACKGROUND: Limited guidance exists on how to design and measure the efficiency and effectiveness of an antimicrobial stewardship program (ASP). Our established ASP sought to broaden interprofessional accountability and enhance our programmatic efficiency by employing Lean Daily Management System (DMS) procedures. METHODS: To improve ASP communication, a visual and systematic approach to identify, address, and resolve ASP projects while quantifying nontraditional metrics measuring the efficiency and effectiveness was developed. Through shared discussions, an interdisciplinary group of stakeholders produced the following deliverables: (a) established shared programming goals/metrics; (b) improved prioritization methods and project tracking through completion; (c) developed readiness and metric boards to display achievements, current activity, and metrics; (d) identified programming threats and strategies to strengthen our provided services. RESULTS: At 6 months following DMS adoption, our ASP has disbanded monthly meetings in lieu of weekly, 15 minute huddles utilizing the readiness and metric boards. We achieved consistent and interprofessional representation where each member is accountable for leading huddles, providing reports, and owning projects. Using a stoplight color system to indicate status, potential ASP influencers are tracked and reported: clinical workload/demands, organizational awareness, equipment/supplies, staffing, project updates, and announcements. The visual identification allows the team to address “quick hits” or escalate resource allocation to solve “big issues” (figure). Program metrics are codified under the domains of delivery, people, quality, safety, and financial stewardship. Administrative leadership has attended huddles and provided positive and constructive feedback to foster a process of continuous improvement. CONCLUSION: Integration of Lean DMS huddles provides a collaborative, interactive and interdisciplinary approach to enhance shared awareness and to broaden the reach and efficiency of our ASP. With project tracking mechanisms in place, our team is refining our problem-solving abilities to ensure a congruent plan between issues raised and established program metrics. [Image: see text] DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6811027 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-68110272019-10-28 1052. Antimicrobial Stewardship: On Board with Lean Daily Management System Monsees, Elizabeth Monsees, Elizabeth Wirtz, Ann Myers, Angela Myers, Angela Burns, Alaina Day, Chris El Feghaly, Rana E Lee, Brian R Purandare, Amol Weddle, Gina Goldman, Jennifer Open Forum Infect Dis Abstracts BACKGROUND: Limited guidance exists on how to design and measure the efficiency and effectiveness of an antimicrobial stewardship program (ASP). Our established ASP sought to broaden interprofessional accountability and enhance our programmatic efficiency by employing Lean Daily Management System (DMS) procedures. METHODS: To improve ASP communication, a visual and systematic approach to identify, address, and resolve ASP projects while quantifying nontraditional metrics measuring the efficiency and effectiveness was developed. Through shared discussions, an interdisciplinary group of stakeholders produced the following deliverables: (a) established shared programming goals/metrics; (b) improved prioritization methods and project tracking through completion; (c) developed readiness and metric boards to display achievements, current activity, and metrics; (d) identified programming threats and strategies to strengthen our provided services. RESULTS: At 6 months following DMS adoption, our ASP has disbanded monthly meetings in lieu of weekly, 15 minute huddles utilizing the readiness and metric boards. We achieved consistent and interprofessional representation where each member is accountable for leading huddles, providing reports, and owning projects. Using a stoplight color system to indicate status, potential ASP influencers are tracked and reported: clinical workload/demands, organizational awareness, equipment/supplies, staffing, project updates, and announcements. The visual identification allows the team to address “quick hits” or escalate resource allocation to solve “big issues” (figure). Program metrics are codified under the domains of delivery, people, quality, safety, and financial stewardship. Administrative leadership has attended huddles and provided positive and constructive feedback to foster a process of continuous improvement. CONCLUSION: Integration of Lean DMS huddles provides a collaborative, interactive and interdisciplinary approach to enhance shared awareness and to broaden the reach and efficiency of our ASP. With project tracking mechanisms in place, our team is refining our problem-solving abilities to ensure a congruent plan between issues raised and established program metrics. [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6811027/ http://dx.doi.org/10.1093/ofid/ofz360.916 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Monsees, Elizabeth Monsees, Elizabeth Wirtz, Ann Myers, Angela Myers, Angela Burns, Alaina Day, Chris El Feghaly, Rana E Lee, Brian R Purandare, Amol Weddle, Gina Goldman, Jennifer 1052. Antimicrobial Stewardship: On Board with Lean Daily Management System |
title | 1052. Antimicrobial Stewardship: On Board with Lean Daily Management System |
title_full | 1052. Antimicrobial Stewardship: On Board with Lean Daily Management System |
title_fullStr | 1052. Antimicrobial Stewardship: On Board with Lean Daily Management System |
title_full_unstemmed | 1052. Antimicrobial Stewardship: On Board with Lean Daily Management System |
title_short | 1052. Antimicrobial Stewardship: On Board with Lean Daily Management System |
title_sort | 1052. antimicrobial stewardship: on board with lean daily management system |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811027/ http://dx.doi.org/10.1093/ofid/ofz360.916 |
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