163 - Automation of an Inpatient Provider Specific Antimicrobial Use Report

Background: The use of individual prescriber report cards has shown to be an effective strategy in optimizing antimicrobial use in the pediatric outpatient setting. This is more difficult in an inpatient setting with prescribing often being done by a resident, but the decisions regarding antimicrobials are often made by the attending physician. This concept was tackled at a tertiary children’s hospital but was a manual and time-consuming process. The purpose of this review is to compare provider specific antimicrobial use between a manual chart review and an automated report.

Methods: An automatic report was developed that calculates antimicrobial days of therapy per 1000 patient days for each Pediatric Intensive Care Unit (PICU) attending provider. The software used was Business Objects that interfaces with the Electronic Medical Record. The provider is attached to daily antimicrobial use based on the attending to write a note that day. The provider was attached to patient days based on the number of days per patient they wrote notes.

Results: One week including 96 patients was chart reviewed and compared to the automated report prospectively. The automatic report days of therapy and patient days per PICU provider were within 10% of the chart review. Two months of the previous manual chart review was compared to the same two months with the automated report, which was also within 10%. Average quarterly hospital PICU antimicrobial days of therapy per 1000 patient days during the calendar year of 2019 in the Pediatric Health Information System (PHIS) were compared quarterly to the automated report, which was also within 10%.

Conclusion: An automated report that connects the attending to antimicrobial orders by attaching it to the note writer was found to be comparable to manual chart review as well as an average of use for the PICU compared to the national database PHIS. This automation can help decrease workload and optimize efforts for specific interventions and education that can be distributed with the PICU attending antimicrobial use report.