Sujith John Chandy (Educator)

Sujith John Chandy (Educator)

Dr. Chandy is a clinical pharmacologist and resource person passionate about antibiotic use. He is affiliated to both CMC Vellore, and Karolinska Institutet Stockholm where his PhD was in this area.

Location Professor, Dept of Pharmacology & Clinical Pharmacology, Christian Medical College, Vellore, TN, India

Activity

  • True, data mining takes time and effort

  • Yes, Louise. Multidisciplinary team approach is ideal. Unfortunately in many hospitals, communication between disciplines is a challenge. This needs to be worked on

  • Good point Antonia. Real time talking is worthwhile

  • A great idea Judith - a competition. I guess, it will work well if we get the baseline monitored first

  • Yes Amin. Hofstede's cultural dimension theory is worthwhile looking at while planning strategies

  • Thanks Eliseo. A holistic approach is always best. However, strategies can start with smaller components and then move towards fulfilling the holistic approach

  • True Louise. It would be sustainable and doable with a little bit of training

  • Thanks Antonia. Using an electronic system is a good idea. However, we need to keep the strategies multi-dimensional as far as possible

  • True Louise. Leaders being on board visibly would definitely help

  • Absolutely Eliseo. Start with the low hanging fruit

  • Yes, Antonia. Control by itself may not work

  • Thanks Antonia. Yes, many countries are in the same situation unfortunately

  • There is no fixed proforma. However the idea is to make the proforma as simple as possible so that sustainability is achieved. Besides antibiotic names and doses, it would be important to convert into defined daily doses. You can then compare every month

  • Evidence presentation and dissemination will give good insight to stakeholders

  • A combination of the above will definitely help

  • True Ysabelle. Optimal human resources is often the key

  • True Lesley. Output is often based on the input

  • Fantastic Alexander

  • Yes, success stories would be great

  • The other aspect is that many hospitals have a high turnover of junior staff and so newcomers need access too

  • Good that you are focussing on specific antibiotics used in certain situations. That is a good approach

  • Yes, Beatrice, access is crucial

  • True, Tracie, the proportion of healthcare professionals in different age groups and their familiarity with technology matters a lot

  • Thanks Ainhoa for both comments. Yes, frontline personnel matter a lot and so too culture and context

  • Yes, Constantinos. It needs constant engagement

  • Thanks Judith. The infection control team would hopefully be able to move the AMS program forward in your hospital

  • Thanks Sadie. Good to see a well oiled structure.

  • Thanks Constantinos. Yes, it would be good to get a buy in from the relevant committees. This can act as a good support in with various departments too

  • Great to see the passion for action Amin

  • Thanks Ainhoa. Well said. The road is not easy, but its worthwhile pursuing and persisting.

  • Thanks Amin. Very positive approach. Lets hope for the best results

  • Yes, Margaret feedback would have really helped

  • Yes, Lesley, low hanging fruit was the first step

  • Absolutely Tracie. It would definitely help

  • All your suggestions would definitely be useful Lucy

  • Thanks Margaret. A mixture of restrictive and encouraging measures would be good, but the setting and culture also needs to be taken into consideration

  • Good idea Ysabelle. Focussing on one antibiotic at a time could be a useful strategy

  • Yes, Lesley. Each strategy has its own problems and chances of success. Cost is a factor too

  • Yes, Alexander. I think a mixture of the above would go a long way to improving use

  • Thanks Beatrice. Good strategies! Monitoring and feedback would be key

  • Thanks Maria. All these would help. Of course the most important challenge would be to develop sustainable strategies to change prescribing and dispensing behaviour

  • Yes, Tracie, I think PDSA cycles would be essential in such areas as AMR problems keep evolving

  • Thanks Ysabelle. It would be good to look at the different patterns of use and resistance in the hospitals since that would determine whether the policies need to be uniform with minor customization in each hospital

  • Thanks Sybille. It looks like you are well on your way. I guess the challenge in such a large hospital would be sustained coverage and human resources

  • Thanks Leonard. Good that the DTC is functioning well and that you have training programs. Have you been able to measure effectiveness of these programs? This would be a good thing to do

  • Thanks Gerardo. Its good that someone has taken the initiative. First thing to do would be to see the pattern of antibiotic use

  • Thanks Leonard. Good that the DTC is functioning well and that you have training programs. Have you been able to measure effectiveness of these programs? This would be a good thing to do

  • Thanks Eugene. Yes, it is a challenging area, but I think the first step would be to monitor antibiotic use and see if there is a problem or not

  • Thanks Badr. Yes, monitoring of implementation would give you the required information on its success, but also allow you to refine the policy considering the current AMR problems in the hospital

  • Thanks Lesley. Yes, each country has different factors and problems at different levels.

  • Thanks Eugene. Yes, it is a challenging area, but I think the first step would be to monitor antibiotic use and see if there is a problem or not

  • Thanks Tracie. Its an unfortunate situation, but I feel that as Lesley mentioned, it would be good to identify someone who has the energy and drive to move the activities forward. This could initially be done with one project and then when people see success, it could revive interest

  • Thanks Margaret. Its good to have wide representation of stakeholders. Try and ensure that you choose people who have the passion in this area.

  • Thanks Tracie. Its an unfortunate situation, but I feel that as Lesly mentioned, it would be good to identify someone who has the energy and drive to move the activities forward. This could initially be done with one project and then when people see success, it could revive interest

  • Thanks Babatunde. You've raised an important point - dissemination of information. Its important to constantly work on strategies to optimize dissemination

  • Yes, somehow we need to convince and encourage our policy makers and leaders to introduce these cost effective measures in a sustainable way

  • Yes, simple things are often most effective

  • Yes. There are multiple pressures on IT within a hospital. Therefore it would be helpful to have user friendly data mining processes

  • Yes, unfortunately, that is the case in many LMIC settings.

  • Absolutely Penny

  • A good idea Kalidi

  • True Penny. ASP success stories are also useful

  • Yes, Kalidi. Periodic feedback would contribute positively to the engagement process

  • Yes, Alexander. Continuous engagement with stakeholders would be key

  • Thanks Sujata. Such programmes are a good idea. In such collective programmes, the idea would be to illustrate problems and give solutions without blaming particular physicians or departments.

  • Yes, Penny, having the policy, but also putting in place audit and feedback would help a great deal

  • Absolutely Zuberi. That is why initiating strategies to counter these trends are so urgent

  • A combination of strategies would be good. Of course, resource limitations maybe there and so you may have to prioritize if so.

  • Great to hear that Penny. Yes, countries are different, but the world needs to come together on the AMR problem and so lets hope that the Global Action Plan will percolate to every country