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Measurement used for improvement

In this article Dr Adrian Brink explains the measurements that were undertaken and disseminated
multicoloured tapes measures fanned out into the shaper of a star
© UoD and BSAC

To facilitate measurement and feedback a “low-hanging fruit” toolkit, consisting of an Excel-based standardised measurement template/tool, was developed and launched in July 2012 for the five interventions.

Part of the template used is presented below:

This is the section of the template created to record progress during the intervention. The template is headed AS Project - Tracking Compliance to an Intervention. There are five columns. The left hand column shows the weeks, then the number of patients reviewed, the total number of patients compliant, % compliance and Median % compliance. (Click to take a closer look)

Once the data had been completed a run chart was generated to use at feedback meetings.

This is the run chart created by the data input into the template. It is entitles Weekly Run Chart: % compliance to stewardship intervention. The y axis shows the % compliance ranging from 0 to 100 and the x axis records the weeks from 1 - 40. The graph shows that improvements were made in compliance between week 28-40 (Click to take a closer look)

All percentages calculated as % of patients seen on clinical pharmacy rounds with:

  • the denominator: the number of patients on antibiotics that were seen by the pharmacist during ward rounds
  • the numerator: the number of patients where the particular “low-hanging-fruit” intervention was implemented.
  • data was collated weekly at each hospital
  • submitted monthly to the AMS project manager.

The WHO ATC index with defined daily doses (DDDs)/100 bed days was adopted as the method of measurement of the impact of the AMS program on overall antibiotic consumption. You may want to revise “Introducing DDDs as a measure” from Week 3.

© UoD and BSAC
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Antimicrobial Stewardship: Managing Antibiotic Resistance

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