Watch the video with Ms Angeliki Messina, the Quality Leadership Project Manager for this South African AS initiative, as she explains the value of her role in co-ordinating data collection, feedback and the shared learning that could be gained through communication.
Ms Messina was appointed (initially) for two days a week to collate and support the implementation. Initial training was provided through face-to-face regional learning sessions with pharmacists representative of all hospitals, as well as to pharmacy managers, nurses and infection prevention practitioners (Learning session 1).
In line with the breakthrough series model, each pharmacist was then required to undertake an implementation process in their hospital including collection of data on a standardised template.
A series of learning sessions were implemented as per this diagram:
Netcare antibiotic stewardship Breakthrough Series Collaborative approach for the group-wide implementation processFollowing Learning session 1, conference calls were held every 6-8 weeks with pharmacists nationally, hosted by the executive sponsor and project manager (Learning session 2, 3, 4, 5 etc). In between the learning sessions support was provided by the project manager. In addition, doctor input was obtained during subsequent 12-monthly, face-to-face regional learning sessions.
As well as the appointment of an AS project manager, “protected” AS time was mandatory and enforced i.e. hospital and pharmacy managers supported pharmacists with time to conduct ward rounds which ranged from an hour a few times a week, to a few hours a day depending on the size of the hospital.
Submission of data for group-wide monitoring was encouraged at first and later made part of a performance management process. No financial incentives were offered. Abstract submission to and attendance at local infectious disease congress meetings were encouraged.