Journal article
Qualitative assessment of antibiotic stewardship teams’ efforts to perform prospective audit-and-feedback at hospital discharge
Antimicrobial stewardship & healthcare epidemiology : ASHE, Vol.6(1), e113
04/01/2026
DOI: 10.1017/ash.2026.10366
Appears in UI Libraries Support Open Access
Abstract
Objective: How antibiotic stewardship programs can effectively reduce antibiotic overuse at hospital discharge is unclear. In this study, we assessed barriers and facilitators to performing prospective audit-and-feedback at this transition of care. Design: A qualitative study using semi-structured interviews. Setting: Ten acute-care hospitals participating in a stepped-wedge cluster-randomized trial, including three Veteran’s Health Administration hospitals, two academic medical centers and five community hospitals Participants: Fourteen antimicrobial stewards in participating hospitals across the United States. Methods (or Interventions): A semi-structured interview guide was created applying the RE-AIM framework to focus on perceptions of implementing the intervention. All interviews were audio recorded, transcribed, and coded in a three-person team. Using thematic analysis, codes were developed and collapsed into themes. Results: Half of the intervention sites struggled to identify patients at discharge, limiting the stewardship teams’ ability to conduct prospective audit-and-feedback at discharge. In contrast, strong provider–stewardship relationships and existing hospital initiatives, such as handshake stewardship and discharge planning meetings, facilitated implementation. Stewardship teams at four sites also reported not needing to guide antibiotic use for patients with Infectious Disease (ID) consults, as they agreed with the documented recommendations from the ID specialists. Conclusions: Our findings underscore the importance of accounting for the hospital and organizational context when implementing discharge-focused audit-and-feedback interventions, paying particular attention to existing policies, procedures, and the dynamics between antibiotic stewardship teams and front-line prescribers.
Details
- Title: Subtitle
- Qualitative assessment of antibiotic stewardship teams’ efforts to perform prospective audit-and-feedback at hospital discharge
- Creators
- DeShauna Dinese Jones - University of IowaEmily E Chasco - University of IowaCody Poe - University of IowaDaniel Livorsi - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Antimicrobial stewardship & healthcare epidemiology : ASHE, Vol.6(1), e113
- DOI
- 10.1017/ash.2026.10366
- ISSN
- 2732-494X
- eISSN
- 2732-494X
- Publisher
- Cambridge University Press
- Grant note
- Centers for Disease Control and Prevention EpiCenter program
This work was funded by the Centers for Disease Control and Prevention EpiCenter program. Colleagues from the CDC did not participate in any of the following activities: design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
- Language
- English
- Date published
- 04/01/2026
- Academic Unit
- Infectious Diseases; Center for Social Science Innovation; Injury Prevention Research Center; Institute for Clinical and Translational Science; Internal Medicine
- Record Identifier
- 9985154652702771
Metrics
1 Record Views